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Full text of "Male psychological adjustment related to early sexual experiences"

MALE PSYCHOLOGICAL ADJUSTMENT RELATED TO 
EARLY SEXUAL EXPERIENCES 



By 

SIDNEY MICHAEL TRANTHAM 



A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE 

UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE 

REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY 

UNIVERSITY OF FLORIDA 

1999 



-...:^^V*,-tO^ 



For all brothers, but especially Jeffrey, David and Seth. 



ACKNOWLEDGMENTS 

My gratitude is extended to each of my committee members for their guidance 
during this project. A special acknowledgment is made for Dr. Duane Dede, who 
encouraged my development as a researcher and a clinician but has also been my friend. I 
will be forever gratefiil for his teaching me to "see the glass as all full." 

This project would also not have been completed without the continuous effort of 
my research assistant, Shannon Rimmer. Her loyalty was inspiring and an essential 
element in completing this project. 

■ As always, there are few words that adequately express my appreciation for the 
endless love and support of my family and friends. Thank you. 



Ill 



TABLE OF CONTENTS 

page 

ACKNOWLEDGMENTS iii 

ABSTRACT vi 

CHAPTERS 

1 INTRODUCTION 1 

2 REVIEW OF LITERATURE 4 

Sexual Development 4 

The Development of Gender Identity 5 

Sex Differences in Behavior 6 

Sexual Identity Development 7 

Sexual Preferences 10 

Anxiety 13 

Parent-child Relationship and Sexual Development 14 

Innate Factors Involved in Sexual Development 15 

Development of Sexual Preferences: Females 16 

Sexual Abuse 17 

Impact of Child Sexual Experiences: Females 20 

Impact of Child Sexual Experiences: Males 22 

Reporting Abuse 25 

Comparison of Male and Female Abuse 26 

Defining Abuse 26 

Symptoms 27 

Racial Issues 29 

3 MATERIALS AND METHODS 35 

Proposal 35 

Hypotheses to Be Investigated 36 

Hypothesis I 36 

Hypothesis II 40 

Hypothesis III 41 

Hypothesis IV 41 



IV 



Subjects 42 

Measures 43 

Demographic Questionnaire 43 

Sexual History Questionnaire 45 

SCL-90-R 49 

Procedures 51 

Analyses 52 

4 RESULTS AND DISCUSSION 54 

Results 54 

Descriptive Statistics 54 

Correlations 59 

T-Tests 60 

ANCOVAs 63 

Chi-Square 67 

Discussion 68 

Review of Purpose 68 

Current Study Findings 69 

Trends ..... .'v. ^v'.'; .-.'. 71 

Measurement Issues 73 

Social Desirability 76 

Unique Sample Characteristics 78 

5 SUMMARY AND CONCLUSIONS 80 

APPENDICES 

A DEMOGRAPfflC QUESTIONNAIRE 84 

B SEXUAL HISTORY QUESTIONNAIRE 87 

REFERENCES 102 

BIOGRAPHICAL SKETCH 106 



Abstract of Dissertation Presented to the Graduate School of the University of Florida 
in Partial Fulfillment of Requirements for the Degree of Doctor of Philosophy 

MALE PSYCHOLOGICAL ADJUSTMENT RELATED TO 
EARLY SEXUAL EXPERIENCES 

By 

Sidney Michael Trantham 
May 1999 



Chairperson: Duane E. Dede, Ph.D. 

Major Department: Clinical and Health Psychology 



There has been increased concern regarding the impact that childhood experiences 
have on development. Research of female childhood sexual abuse has found that adult 
women who report sexual experiences in childhood with older adult men often exhibit 
higher levels of anxiety and depression compared to their non-abused peers. However, 
there are few studies of male childhood sexual abuse and even fewer which examine a 
non-clinical population. 

One hundred thirty college males between the ages of 1 7 and 47 volunteered as 
subjects. Subjects anonymously completed three questionnaires: a demographic 
questionnaire, the Sexual History Questionnaire, and the Symptom Checklist-90-Revised 
(SCL-90-R). 



VI 



Results indicate that for this sample of college males, there was little difference in 
level of general psychological distress based on sexual experiences in childhood, as 
measured by a self-report scale. Subjects unanimously identified themselves as 
heterosexual, and the majority of subjects who reported a sexual experience in childhood 
consistent with this study's definition of sexual abuse indicated that the older partner was 
female. Few subjects rated their experience as unpleasant or having a negative impact on 
their lives. Although no statistical significance could be found, subjects who reported a 
sexual experience in childhood consistent with sexual abuse evidenced slightly higher 
mean t-scores on the SCL-90-R. Level of parental support, age at time of sexual 
encounter, and gender of the perpetrator had little impact on ratings of level of 
psychological distress. 

It is still unknown if there are significant negative emotional symptoms for men 
who are sexually abused as children. This study's data suggests that whatever impact 
remains in aduh life is clinically mild. The limited sample size and mild magnitude of 
this phenomenon suggest caution in generalizing these findings. Future research in this 
area should include larger sample sizes, assessment of male subjects' perception of 
male/female gender roles as a possible mediating factor in response to sexual experiences 
in childhood, and multiple data collection methods. 



Vll 









- : CHAPTER 1 

INTRODUCTION 

Within the past decade, there has been increased concern regarding the impact that 
childhood experiences have on development. Parents and consumer groups have 
organized to protest what they perceive as the increasing violence in various media, 
suggesting that children exposed to violent acts will suffer detrimental effects such as 
decreased empathy and increased aggressive behavior. Lobbying on behalf of such 
beliefs has resulted in significant changes in all forms of popular media, including 
children's television programming, movies, music, and video games; each of these areas 
now has explicit guidelines for what is acceptable as well as recently constructed 
"parental advisory" and "violence level" warnings. 

Similar concerns about child development have led to research on children's 
reaction to abuse. There are several methodological difficulties inherent in child abuse 
research, the most prominent being the retrospective nature of most studies and the 
significant amount of concurrent forms of abuse, such as physical abuse and emotional 
neglect, sexual abuse and physical abuse, neglect and emotional abuse. Continued 
refinement of research methodology has gradually led to a vast amount of knowledge on 
specific forms of abuse. It appears that there is no specific outcome following abuse, but 



rather a multitude of outcomes dependent on several factors. While there are some points 
that researchers continue to dispute, most agree that child abuse negatively affects the 
psycho-social development of the child. 

Research on child sexual abuse has predominately been based on the maltreatment 
of females. While the abuse of females in this society is clearly significant, there is 
increasing evidence to suggest that the sexual abuse of males is more prevalent than 
previously believed. There have been a limited number of studies examining the 
immediate outcome of sexual abuse for males, and even fewer studies examining the 
long-term correlates of childhood sexual abuse of males. In addition, research findings 
are more inconsistent within the area of male childhood sexual abuse, and there is little 
comparability between studies of female childhood sexual abuse and male childhood 
sexual abuse. 

One explanation for the contradictory findings in the literature on male childhood 
sexual abuse is the reliance on measures of sexual behaviors as the outcome. Sexual 
functioning is often used as the barometer of psychological adjustment in males, this may 
not be an accurate assumption. In addition, many studies of male childhood sexual abuse 
are descriptive in nature, and there is evidence that males are reluctant to acknowledge 
sexual abuse due to strong societal notions of masculinity. The Symptom CheckList 90- 
Revised is a well-standardized measure of psychological adjustment that has been used 
frequently in studies examining the sequelae of sexual abuse of females. There is limited 
literature of the SCL-90-R's use in studies examining the sequelae of sexual abuse of 
males. 



3 

The purpose of the present study was to examine the psychological adjustment of 
adult men who reported childhood sexual experiences consistent with criteria for 
childhood sexual abuse. It was anticipated that the use of measures previously used in 
studies of both male and female sexual abuse would clarify previous findings in the 
literature as well as allow comparison across studies. It was also anticipated that distinct 
groups of adults would be present when additional factors such as gender of the abuser, 
age at time of abuse, and other family variables were accounted for. 



CHAPTER 2 
REVIEW OF LITERATURE 

Sexual Development 

Various theoretical models have been proposed to explain the sexual development 
of humans. Few of these models predict how an individual's development will proceed, 
and prediction becomes near impossible when sexual development is viewed through any 
single explanatory process (Bancroft, 1989). Argument continues as to whether sexual 
development depends on innate factors (nature) or environmental factors (nurture), but it 
has become increasingly clear that the issue of sexual development is not an "either/or" 
case. There is some consensus that on a general level, sexual experiences in childhood 
have an impact on sexual development and later sexual behavior. This suggests that there 
are many points along the path of sexual development that are disrupted by an experience 
of sexual abuse. 

Sexual abuse during childhood and adolescence may lead to concerns about 
sexual identity and sexual performance. Abused males frequently have concerns about 
their masculinity, being homosexual, and being sexually attractive (Faller, 1989; Gilgun 
&. Reiser, 1990, Krug, 1989; McLaren & Brown, 1989). In an attempt to understand 
relationships with others, the male who has been victimized frequently seeks to define 



*■■■-■- 5 

what is normal; how does the typical male demonstrate maleness, what is acceptable 
sexual behavior, and what does it mean to be a victim of sexual abuse for future 
relationships? 

The Development of Gender Identity 

Gender can be manifested in at least seven levels: chromosomes; gonads; 
hormones; internal sexual organs; external genitalia and secondary sexual characteristics; 
the gender assigned at birth ("It's a boy"); and gender identity ("I am a girl"). Each of the 
above levels leads to the next as part of the development process. The last two, gender 
assignment and gender identity, are of interest for the purpose of this examination of 
sexual development. 

How a child develops in terms of psychological gender depends in large part to 
how he or she is brought up. How that child is brought up depends on the initial 
observation of anatomical gender— "it's a girl." If anatomical development has proceeded 
normally, this initial observation and gender assignment should not be a problem. 
However, if anatomical development has not proceeded normally, there may be ambiguity 
of the external genitalia which can lead to an arbitrary gender assignment for the child. 

Case studies of psuedohermaprodism and ambiguous genitalia have examined the 
psychological gender of the child and suggest that there is a critical stage in psychological 
development when the belief ("I am a female" or "I am a male") becomes fixed (Bancroft, 
1989). This point is often referred to as the core gender identity and occurs between the 
ages of two and four (Cole & Cole, 1989; Gleitman, 1987). It is hypothesized that core 
gender identity development is related to the stage of cognitive development when gender 



- T • . ■■ .■'>J^ ■ 



begins to have meaning (Cole & Cole, 1989; Gleitman, 1987). There is uncertainty about 
how fixed the core gender identity remains after this critical phase, and whether 
reassignment can successfully occur at a later stage. Bancroft (1989) cites evidence of 
one case in which incorrect assignment was successftilly reversed as late as 13 or 14 years 
of age. Bancroft suggests that the successful gender reassignment may depend on the 
degree of uncertainty about the child's identity in the first place. If, by the age of 4, a 
child feels unquestionably female (or male), then later attempts to change identity will 
probably fail; however, if the child is still questioning gender identity and feels 
uncomfortable with the assigned gender, then reassignment may be very successfiil even 
at a relatively late stage of development (Bancroft, 1989). 

Sex Differences in Behavior 

In addition to the core gender identity, a child develops a sense of masculinity or 
femininity and expresses this through typically masculine or feminine behaviors (Cole & 
Cole, 1989, Gleitman, 1987). In American society, boys show more physical activity 
such as rough and tumble play, more active physical exploration, and interest in war 
games; girls typically engage in more domestic play. These are generalizations that apply 
to the majority, but are culture specific; other societies may have the reverse. This raises 
the controversy of how much gender roles are socially determined versus how much 
gender roles are due to inherent qualities about males and females. To what extent is 
typical boy and girl behavior learned? 



7 

Sexual Identity Development 

Bancroft (1989) proposes a 3-stage model of sexual identity development: 

1. pre-labeling stage : when childhood and early adolescent sexual experiences occur 
without the need to categorize them as either homo- or heterosexual. 

2. self-labeling stage : at some stage the individual asks the question "Am I straight 
or gay?" and begins to interpret experiences as evidence for or against. 

3. social labeling : at some later stage, the social world asks the same question about 
the individual, influencing the cognitive learning process and reinforcing labels as 
well as providing the underlying assumption: "You are either one thing or the 
other," 

One of the most significant periods of gender and sexual identity development 
occurs during transition from childhood to adolescence (Bancroft, 1989; Gilgun & Reiser, 
1990). There are important hormonal changes during this period, as well as 
psychological changes. Prior to this stage, a pre-pubertal child may have become 
extremely competent and confident in his or her childhood gender role, and may become 
confijsed about that role by the changes that occur during puberty (Bancroft, 1989). For 
example, changes in the body appearance and shape may produce a phase of uncertainty 
about the future, e.g., "will I always look like this?" In conjunction with dramatic 
physical changes, there are also accompanying emotional changes such as feelings of 
social awkwardness and emotional instability, partly due to hormonal changes. And 
finally, the rules about the relationship between males and females change, as sexuality 
becomes a very important aspect of gender (Bancroft, 1989). Success in sexual 



8 

encounters may be used to bolster self-esteem or exert control or dominance 
(Giannandrea, 1985; Gilgun & Reiser, 1 990) . 

Some adolescents postpone their entry into this sexual phase of development, 
substituting nonsexual supports for both their gender identification and self-esteem 
(Bancroft, 1989). For example, a boy may concentrate on a sport, justifying avoidance of 
sexual contact as a necessary part of his dedication (Bancroft, 1989). This may be 
effective to some degree, but it also serves to alienate him from his peers and delay 
learning how to manage male-female relationships. For other adolescents, early attempts 
at forming sexual relationships are largely aimed at proving their newly reestablished 
gender identity; such adolescents are likely to seek multiple sexual experiences as a way 
to assert their masculine or feminine gender identity (Giannandrea, 1985; GofF, 1990). 

Kagan and Moss (1962) assessed the degree of heterosexual interaction (i.e., 
interaction with children of the opposite sex) and opposite sex activity (i.e., interest in 
and practice of activities traditionally associated with the opposite sex) at different stages 
of childhood and adolescence. Between the ages of six and 10, boys and girls played 
predominantly in same-sex groups. Children, especially boys, who did not conform in 
this respect were often rejected by their same-sex peers (Kagan & Moss, 1962). With 
opposite sex activity they again found greater predictability in boys than girls. Even as 
young as three to six years, the extent of opposite sex behavior was highly correlated with 
opposite sex behavior of adults. Competitiveness and involvement in mechanical, gross 
motor and aggressive games during the preschool years were prognostic of sex role 
activities 20 years later (Kagan & Moss, 1962). In another study of preschool children, 
boys who engaged in stereotypical feminine behavior received a considerable amount of 



disapproval from their peers, and to a lesser degree from their teachers (Fagot, 1977). 
This pattern was not observed in girls. Fagot asked the interesting question of why this 
behavior persisted in the face of such unremitting discouragement, and suggested that 
either opposite influences in the child's home were operating or possibly some biological 
factor, unresponsive to social learning, was involved. 

Kagan and Moss (1962) also assessed anxiety about sexual behavior at the late 
adolescent and early adult stages. For the boys, but once again not for the girls, the 
absence or lack of clearly masculine behavior between the ages of 3 and 10 years was 
associated with greater anxiety about sex in early adulthood. In addition, early masculine 
behavior was predictive of earlier dating and involvement in erotic heterosexual activity 
during adolescence. 

The timing of puberty also has a bearing on gender identity, sexual identity, and 
personality development (Bancroft, 1989). Boys who are late in reaching puberty tend to 
be less popular and less assertive. "Manliness" and sexual vigor are highly regarded 
attributes among adolescent males, and boys who have not reached puberty by 1 6 years or 
so may begin to doubt their masculinity and become anxious and introspective about their 
development; girls' reactions to early or late puberty are more complex and there are 
fewer clear advantages to early maturation in females (Bancroft, 1989; Kinsey, Pomeroy, 
& Martin, 1948). 

Adolescence is the period where gender identity, sexual responsiveness, and 
sexual preferences are becoming integrated (Giannandrea, 1985; Gilgun & Reiser, 1990; 
Gleitman, 1987; Goff", 1990). Gender identity continues to undergo periods of change 
with increasing age. Work role identity becomes an important aspect of gender identity 



\kd:::,/i 



10 

during early adulthood. Work role identity tends to reflect the prevailing sex role 
stereotypes; for males, the work role tends to bolster a sense of masculinity, while for 
females it generally produces conflicts with her femininity (fears that being successful in 
a career will make her less attractive as a woman and less successful as a mother) 
(Bancroft, 1989; Cole & Cole, 1989). 

Other factors such as work, parenthood, and hobbies gradually begin to reinforce 
gender identity, and it becomes less necessary to rely on sexuality to define one's gender 
identity. This change in what reinforces gender identity allows for the establishment of 
mutually rewarding and mature sexual relationships (Bancroft, 1989). Each partner is not 
working toward incompatible goals through their sexual exploits, and thus they 
concentrate more on establishing intimacy and forming a relationship. However, if one 
partner experiences a crisis in a nonsexual area (such as the threat of losing a job), a 
previously stable sense of gender identity may be undermined. Such a threat to gender 
identity may result in a regression in the individual's use of sexuality, and sexual 
relationships may be exploited to bolster self-esteem (Bancroft, 1989; Giannandrea, 
1985). 

Sexual Preferences 

Sexual preference indicates the type of person (or thing) and/or type of activity 
with that person that is most Ukely to evoke sexual interest and arousal. The choice of 
partner may reflect other needs of equal or greater importance than the experience of 
sexual pleasure (e.g., marrying for money rather than love). A controversy arises between 
those who see sexual preference as a manifestation of early organization or learning and 



-rf r ■, 1 I. 



i 11 



those who see it as a product of an ongoing development process that is malleable 
(Bancroft, 1989; Cole & Cole, 1989; Gay, 1989; Giannandrea, 1985; Gleitman, 1987; 
Kagan & Moss, 1962; Kinsey et al., 1948; Seligman & Hager, 1972). Most 
psychoanalytic theories emphasize the importance of early experience in determining later 
sexual preference (Cole & Cole, 1989; Gay, 1989; Gleitman, 1987). Theoretical models 
posited from such positions are frequently difficult to test. 

The most important dimension of sexual preference is the gender of the preferred 
partner. Are we attracted to someone of the same gender, different gender, or both 
genders? Are sexual preferences predominately homo- or heterosexual? Connected to 
this is the type of person we are attracted to: businesswoman or housewife, jock or 
bookworm? Although there are themes shared with other people, each person is unique 
in his or her pattern of preferences (Bancroft, 1989; Cole & Cole, 1989; Kinsey et al., 
1948). This factor is important because it determines the type of relationship we will 
have with others (Bancroft, 1989; GoflF, 1990). For example, a person attracted to 
married men will have a different type of relationship with men (and women) than a 
person attracted to single males. Other qualities which factor into what we consider 
sexually attractive include such things as body shape, facial characteristics, age, and body 
movement or behavior (Bancroft, 1989, Cole & Cole, 1989; Kinsey et al., 1948). 

Another characteristic of human sexuality is the person's tendency to prefer 
certain kinds of sexual activity. Preferences for particular types of sexual activity also 
vary from person to person, and this variability also influences the nature of our 
interpersonal relationships. People vary in their preference for certain positions during 
intercourse, oral-genital or anal stimulation (Bancroft, 1989, Gilgun & Reiser, 1990; 



12 

Kinsey et al., 1948). If our preferences in sexual activity match our partner's, then they 
may strengthen or at least enhance the relationship (Bancroft, 1989). However, if they are 
unacceptable or threatening to our partner, then the relationship may be weakened or even 
destroyed (Bancroft, 1989; Goff", 1990), 

There is considerable debate regarding how sexual preferences are established, 
with much of the controversy surrounding two aspects of the above: what physical 
characteristics are considered sexually attractive and what gender we are attracted to. 
Often a "nature/ nurture" debate ensues when discussions of the establishment of sexual 
preferences, with some suggesting sexual preferences are learned behaviors and able to be 
changed, while others suggest sexual preferences are biologically determined and 
immutable (Cole & Cole, 1989; Fagot, 1977; Gay, 1989; Giannadrea, 1985; Gleitman, 
1987; Kagan & Moss, 1962; Kinsey et al., 1948; Seligman & Hager, 1972). 

There is some indication that society influences what is considered sexually 
attractive and acceptable (Bancroft, 1989; Giannandrea, 1985). For example, it has been 
suggested that what is considered attractive varies according to gender and the times. 
Men are typically described as placing an emphasis on more physical and visual 
attributes, while women often are described as having a wider range of qualities that they 
find attractive, including social class, wealth, or power (Bancroft, 1989, Cole & Cole, 
1989; Giannandrea, 1985; Gleitman, 1987). During the 15th century, Botticelli painted 
women that were considered highly desirable due to their "fiill figured" and "voluptuous" 
forms; Calvin Klein currently showcases the latest trend toward younger, prepubescent 
looking women being considered highly desirable. Similar to this, women with thin, 
demure lips were highly sought after by men at one time; recently women with fiiUer lips 



13 

have been considered more sexually attractive, and have led to a significant number of 
women seeking cosmetic surgery to achieve this quality. Bancroft (1989) also noted that 
review of the literature suggests that in societies and time periods with a stronger 
patriarchical influence, homosexuality is not tolerated and frequently persons exhibiting 
such behaviors are persecuted; in contrast, societies and time periods with a stronger 
matriarchical influence at a minimum tolerate homosexual relationships. 

Anxiety 

Anxiety associated with certain types of sexual activity or partner may "push" a 
person away from such a preference. Two types of threats may be involved, including 
fear of failure and fear of success (Bancroft, 1989; Cole & Cole, 1989; Gleitman, 1987). 
Fear of sexual failure or rejection by a sexual partner is usually associated with lack of 
self-confidence or low self-esteem, or uncertainty about one's gender identity, sexual 
attractiveness, sexual competence or sexual preference (Bancroft, 1 989; Briere & Runtz, 
1988; Faller, 1989; Finkelhor, 1990; Gilgun & Reiser, 1990). For example, a man unsure 
of his masculinity or attractiveness to women may feel safer in sexual involvement with 
another male (Gilgun & Reiser, 1990; Goff, 1990; Harry, 1989). Fear of success is the 
fear of the actual sexual encounter, this is often related to guilt about sexual enjoyment or 
fear of its consequences, learned during childhood and is often reinforced by a sexually 
repressive environment (Bancroft, 1989; Gay, 1989). The Oedipus complex, a central 
aspect in the psychoanalytic theory of sexual development, is an example of this guilt or 
anxiety about the sexuality of one's relationship with the opposite-gender parent (Gay, 
1989). If a boy learned to be threatened by the sexual implications of his relationship 



14 

with his mother, he may avoid sexual relationships that appear similar, such as women 
who appear similar to his mother, relationships involving love, or heterosexual 
relationships altogether (Bancroft, 1989; Gay, 1989). 

Anxiety may also act to "pull" a person toward certain preferences (Gilgun & 
Reiser, 1990, Harry, 1989, Muehlenhard & Cook, 1988). An example would be where 
sexual activity becomes a method of dealing with a threatening relationship; homosexual 
relationships in prisons frequently involve one partner who engages in homosexual 
behaviors due to anxiety and fears about what would happen to him if he did not (Myers, 
1989). Again, psychoanalytic theory suggests that during the Oedipal phase of 
psychosexual development, males may cope with a threatening male figure by developing 
homosexual preferences (Bancroft, 1989; Gay, 1989). 

Parent-child Relationship and Sexual Development 

As noted above, psychoanalytic theory implicates the parent-child relationship as 
a significant factor in the sexual development of children. Theorists suggest that 
particular types of mothering techniques may lead to specific forms of male sexual 
development; for example, mothers that are described as binding and overly intimate with 
their sons are commonly cited for being related to males developing a homosexual 
identity (Bancroft, 1989; Gay, 1989; Pierce & Pierce, 1985). Others focus on the father- 
son relationship; fathers ranging from absent, to detached, to hostile have been implicated 
in the cause of male sexual disorders (Giannandrea, 1985; Harry, 1989; Violato & 
Genius, 1993). However, much of the support for such theories rests on examining 
psychiatric populations, and other evidence suggests that the child's gender identity 



15 

problems influence the parent-child relationship. Thus, rather than parental behaviors 
causing the child's homosexual behaviors and subsequent parent-child discord, the child's 
atypical gender role behaviors may cause disturbed parent-child relationships (Bancrofl;, 
1989; Benedict (feZautra, 1993; Fagot, 1977; Finkelhor, 1994; Harry, 1989). 

Innate Factors Involved in Sexual Development 

It has also been theorized that learning does not play a major role in sexual 
development, and that humans are born programmed to learn certain things more than 
others (Bancroft, 1989; Gay, 1989; Giannandrea, 1985). Seligman and Hager (1972) 
coined the term "preparedness for learning," which means that there is something innate 
which makes us particularly susceptible to certain types of environmental influence. This 
seems to make sense when considering the preference for same-gender (homosexual) 
activities and cross-gender (heterosexual) activity. Support for innate factors is best 
represented by genetic research, which finds a greater concordance for homosexuality 
amongst monozygotic twins than dizygotic twins (Bancroft, 1989). In addition, it is 
common clinical experience that some men have sexual preferences so fixed and specific 
that they must resort to specific fantasies and activities in order to get any sexual pleasure 
(Bancroft, 1989, Goflf, 1990, Kinsey et al., 1948). For example, men who can only 
experience sexual pleasure when their sexual partner is a small, large breasted woman 
with small hips and large thighs. Proponents of such a biologically driven model of 
sexual behavior suggest that there is an innate drive in heterosexual men to find such 
women more attractive in order to ensure the continuation of the species (Bancroft, 1989; 
Giannandrea, 1985). For the majority of persons (heterosexual and homosexual), there is 



■■■' J 



16 

some sexual adaptability, but the above does suggest that sexual preferences are not 
entirely based on learning experiences. 

Development of Sexual Preferences: Females 

The preceding review of sexual development began by describing general issues 
and factors common to males and females, and then gradually became more focused on 
male sexual development. While the sexual development of females is just as important 
and complex, the scope of this study is to examine the psychosexual development of 
males. It is assumed that many of the mechanisms that underlie male sexual development 
are present in female sexual development. However, females evidence differences that 
may elaborate on male sexual development. 

For example, the more bizarre and fetishtic types of preferences common to males 
are rarely, if ever, seen in females (Bancroft, 1989; Gay, 1989). While women have been 
shown to exhibit sadomasochistic tendencies to a limited extent, they do not develop 
fetishes and rarely participate in antisocial sexual behaviors such as voyeurism (Goff, 
1990; Krug, 1989; Peluso & Putnam, 1996). Sexual abuse of children by women occurs 
more than originally believed, but is undoubtedly less common than abuse perpetrated by 
males (Faller, 1989, Finkelhor, 1990; Krug, 1989, Metcalfe, Oppenheimer, Dignon &. 
Palmer, 1990; Muehlenhard & Cook, 1988; Myers, 1989; Peluso & Putnam, 1996; 
Roane, 1992; Watkins & Bentovim, 1992). Some researchers of sexual behavior also 
suggest that while women do develop homosexual preferences, they may be less frequent 
than males (Bancroft, 1989; Faller, 1989; Gay, 1989). It has been speculated that because 
females do not have as clear a genital signal (e.g., penile erection) as males do from 



17 

arousing visual stimuli, females are less likely to learn sexual responses to both "normal" 
and "abnormal" stimuli (Bancroft, 1989). This explanation is often used in support of the 
common view of adolescent female sexuality as less genitally oriented (Bancroft, 1989; 
Gay, 1989). 

Sexual Abuse 

Estimates of the number of child abuse and neglect cases in the United States 
range from approximately 500,000 per year to as high as 2.3 million (Widom, 1989). 
Reports of the prevalence of sexual abuse of females range from 6% to 62% (Carlin &. 
Ward, 1992, Metcalfe et al., 1990). Reports of the prevalence of male sexual abuse range 
from 3% to 30% among men, with the general consensus among researchers that 
prevalence is quite high (Carlin & Ward, 1992; Faller, 1989; Finkelhor, 1990). In 1995, 
local child protective service agencies identified 126,000 children who were victims of 
either substantiated or indicated sexual abuse; of these, 75%) were girls (Department of 
Health and Human Services, Administration for Children and Families, 1995). In 1995, 
32,130 males age 12 and older were victims of rape, attempted rape or sexual assault 
(Bureau of Justice Statistics, U.S. Department of Justice, 1996). 

Finkelhor's review of the literature included examination of early and long-term 
effects of sexual abuse. Empirical studies he reviewed affirmed the presence of a variety 
of symptoms in children immediately following sexual abuse. Such symptoms include 
fear, anxiety, depression, anger, and sexually inappropriate behaviors (Finkelhor, 1 990). 
Childhood sexual abuse appears to be related to increased adult psychopathology and 
symptoms, long-term symptoms commonly cited following sexual abuse include 



18 

depression, self-destructive behavior, anxiety, poor self-esteem, sexual maladjustment, 
substance abuse, and difficulty trusting others (Carlin & Ward, 1992; Finkelhor, 1990). 
Personality disorders have also been found to be associated with childhood trauma. Most 
notably, borderline personality disorder and sexual abuse have been linked with 
childhood sexual trauma (Carlin & Ward, 1992). 

However, while there tends to be a greater incidence of personality disorders 
associated with a history of child sexual abuse or adult sexual assault, no single diagnosis 
has been particularly associated with child sexual abuse (Carlin & Ward, 1992). This has 
led many researchers to conclude that abuse may be a general, nonspecific factor which 
contributes to psychopathology. In general, it is believed that abused children's emotional 
and behavioral development will be affected by such factors as the age that abuse begins, 
the nature of the abuse, and other environmental factors. For example, research by 
Williamson, Borduin, and Howe (1991) found significant differences in the behaviors of 
groups of adolescents who had been neglected, physically abused, and sexually abused as 
compared to a non-maltreated comparison group. In general, their findings suggest that 
adolescents who were primarily neglected tended to be socially withdrawn, while 
adolescents who were primarily physically abused exhibited a higher frequency of 
externalizing behaviors, and adolescents who were primarily sexually abused exhibited 
the highest frequency of internalizing behaviors, as measured by the Revised Behavior 
Problem Checklist by Quay and Peterson (Williamson et al., 1991). 

Central aspects involved in the sexual abuse of children is the betrayal of trust 
between the adult and child, coercion (both subtle and overt), and physical violation 
(McLaren &. Brown, 1989). Research is currently examining the relationship between the 



19 

developmental level of the abused child at the time of abuse and the sequelae that follow 
the abuse. In general, sexually abused children of all ages have been described as in a 
state of emotional and moral confusion (McLaren & Brown, 1989). Young school age 
children may not fully comprehend what is happening to them but tend to have a general 
sense that something is wrong (McLaren & Brown, 1989). They tend to present with 
symptoms such as a variety of sleep disturbances (insomnia, nightmares, enuresis, and 
sleepwalking), as well as various somatic complaints (abdominal pain, headaches, 
gynecological problems) (McLaren & Brown, 1989). 

Older children who have been sexually abused often are described as guilty, 
blaming themselves partly for the abuse, as well as exhibiting more acting out behaviors, 
such as running away, and also more self-destructive behaviors, such as substance abuse 
and actual or attempted suicides (McLaren & Brown, 1989). And finally, a common 
observation of children who have been sexually abused is that they exhibit sexual 
knowledge and behaviors inappropriate for their level of development, often resulting in 
their sexualizing their relationships with others and behaving promiscuously (McLaren & 
Brown, 1989). 

Carlin and Ward (1992) suggest that childhood sexual abuse is likely to produce 
gradations of changes in thinking, behavior, and symptoms that are best characterized by 
dimensional scales. These authors question the use of categorical systems such as the 
Diagnostic and Statistical Manual—Fourth Edition (DSM-IV) (American Psychiatric 
Association, 1994), which they see as too insensitive to detect many of the behavioral 
gradations and tendencies seen following childhood sexual abuse (Carlin & Ward, 1992). 



20 
Impact of Child Sexual Experiences: Females 

Investigators have usually compared abused and non-abused women as if abused 
women form a homogenous group. Both clinical experience and the lack of specific 
effects suggest that abused women are not homogenous in their response to their abuse. 
Some of the heterogeneity may be due to differences in abuse history. Briere and Runtz 
(1988) found that more symptoms in college students were associated with more invasive 
forms of abuse, greater duration of abuse, and a number of experiences. 

Carlin and Ward (1992) used the MMPI to examine a population of psychiatric 
inpatient women who had histories of varying abuse. The authors hypothesized that 
subgroups of women with greater pathology would be characterized by younger age of 
victimization, greater invasiveness of the experience, higher frequency and greater 
duration of victimization, and a within-family relationship to the perpetrator (Carlin & 
Ward, 1992). Cluster analysis of the women's MMPI revealed four clusters, with abuse 
history significantly related to cluster membership (Carlin & Ward, 1992). The authors 
found that the prevalence of abuse in one of their subgroups was higher than the base rate 
of abuse for a psychiatric population, while lower among members of another subgroup 
(Carlin & Ward, 1992). 

The authors concluded from their findings that the overall high prevalence of 
abuse in psychiatrically hospitalized women suggested that sexual abuse engenders an 
increased risk of severe psychiatric disorder, but without specificity in regard to type of 
disorder (Carlin & Ward, 1992). Carlin and Ward (1992) also found greater invasiveness 
scores among women diagnosed as suffering from personality disorders, leading the 
authors to conclude that although experiencing sexual abuse may not predispose its 



.21 

victims to a specific diagnosis, more offensive forms of abuse may be associated with 
more persistent and embedded forms of psychopathology. Their data did not support the 
hypothesis that specific aspects of abuse such as chronicity, frequency, and relationships 
to the perpetrator would be associated with specific diagnoses (Carlin & Ward, 1992). 
The authors conclude that sexual abuse does not have a single outcome in terms of 
psychopathology and note the need to examine other factors that shape women's 
responses to sexual abuse, including coping styles and the role of support and 
intervention (Carlin «& Ward, 1992). 

Roland, Zelhart, and Dubes (1989) examined three groups of college women who 
reported differing child/adult sexual contact, contact with father/stepfather, with other 
persons, and a control group which reported no such experiences. The authors used the 
MMPI as a measure of psychological adjustment. Mean MMPI validity and clinical 
scales showed the father/stepfather group to have several subscales elevated in the 
clinical range, including scale F, scale 2 (Depression), scale 4 (Psychopathic Deviate), 
scale 7 (Psychasthenia), and scale 8 (Schizophrenia) (Roland et al., 1989). None of the 
subscales for the remaining groups were elevated. 

In a similar study, researchers examined the ability of the MMPI to uncover 
histories of childhood abuse in adult female psychiatric patients (Goldwater & Duffy, 
1990). More specifically, the researchers examined the relationship between the standard 
and extended Scarlett O'Hara V MMPI configuration and histories of nonsexual abuse, 
sexual abuse, alcoholic caretaker, and combinations of the above (Goldwater & Duffy, 
1990). The Scarlett O'Hara V configuration generally refers to MMPI profiles that have 
scale 5 (Masculinity/Femininity) at T score below 35, with scale 4 (Psychopathic Deviate) 



.\J: . i 



22 
scale 6 (Paranoia) at T scores 65 or above (Goldwater & Duffy, 1989). Combining blind 
raters reviews of patient charts for histories of abuse with MMPI profiles obtained at 
admittance, the authors concluded that the MMPI Scarlett O'Hara V configuration 
significantly predicts histories of childhood abuse or alcoholic family environment 
(Goldwater & Duffy, 1989). 

Impact of Childhood Sexual Abuse: Males 

Finkelhor (1990) suggests that close to one-fourth to one-third of all victims of 
sexual abuse are boys based on meta-analysis of the literature. Determining the 
prevalence of sexual abuse of males is hindered by many of the same obstacles that exist 
in the research in sexual abuse of females. Sexual abuse runs the continuum from 
exposure to sexual situations inappropriate for the child's age to genital fondling to 
sodomy; researchers frequently do not elaborate on the criteria used to define abuse, 
making it difficult to compare results across studies (Widom, 1989). In addition, relying 
on subjects' retrospective memories of experiences may not provide accurate information. 
Some obstacles in doing research on child sexual abuse may be unique to males. Social 
role expectations work against male reporting of sexual abuse, as males are frequently 
socialized to be self-reliant and strong, and being identified as sexually abused is viewed 
by many to represent lack of masculinity, homosexuality, or mental weakness 
(Hernandez, Lodico, & DiClemente, 1993). 

Fromuth and Burkhart (1989) criticize the descriptive nature of studies of male 
sexual abuse, noting that they typically have focused on such issues as incidence rates and 
have been less methodologically sound than research with females. Research 



23 

investigating the sexual abuse of males commonly has not used established, valid, and 
meaningful measures, relied more on subject self-definition of abuse, and has involved 
less comprehensive examination of sexual behavior and experiences as compared to 
research investigating sexual abuse of females (Fromuth & Burkhart, 1989). 

Investigations of the sexual abuse of males typically involve case studies and 
description of the etiology, variation, and long-term consequences; there has been little to 
no systematic investigation of male sexual abuse. One reason for this is that males 
typically report such events during the course of psychotherapy. Krug (1989) reviewed 
eight therapy case histories in which mothers sexually abused male children. He 
concluded based on therapy experience that while the sample was small, there was little 
question that each of the men was pathologically affected by the sexual abuse. All eight 
cases demonstrated impaired ability as adults in relating to others in an intimate, 
sustained, and meaningful manner (Krug, 1989). The author noted that 88% of the 
subjects fit DSM-III criteria for Dysthymic Disorder (Krug, 1989), and 63% of the men 
were involved in drug abuse. The author noted significant sexual identity issues in each 
of the cases. 

Female pedophilia has been reported as rare, with women being viewed as 
sexually harmless to children (Krug, 1989). The literature examining the sexual abuse of 
male children by mothers is lacking in comparison to the literature on sexual abuse of 
female children by fathers and stepfathers. One figure cites approximately 1% of all 
incest cases include mother-son incest. Typical explanations for why the incidence of 
mother-son incest is so low is that there is a strong cultural taboo due to the mother's 
primary caretaker role and the obvious opportunity for sexual abuse being so high, and 



24 

the pure physical aspects of intercourse in a mother-son incestuous relationship limit the 
sexual abuse of males by their mothers (Krug, 1989). Mothers who do engage in 
incestuous relationships with their sons are often described as "psychotic," which serves 
to support the idea of the strong societal taboo, and thus, avoidance of this topic as an 
area of research. 

Fromuth and Burkhart (1989) examined the psychological adjustment of two 
samples of college age men with histories of childhood sexual abuse. These authors 
noted that long-term effects frequently associated with childhood sexual abuse, such as 
anxiety, depression, poor self-esteem, feelings of isolation and stigma, difficulties in 
trusting others, self-destructive behaviors and sexual maladjustment, were limited to 
studies of sexually abused females; there has been little research addressing the long-term 
psychological correlates of sexual abuse of males. Fromuth and Burkhart (1989) posited 
that based on the different socialization experiences of males and females, there may be a 
different effect of sexual abuse based on gender. Using a broad definition of sexual abuse 
that included both contact and non-contact experiences, they interviewed two samples of 
college men (a total of 582 subjects) who reported sexual experiences with older females. 

The authors used several survey instruments; a modification of the childhood 
sexual victimization questionnaire originally developed by Finkelhor (1979), Finkelhor's 
Sexual Self-Esteem scale, the Hopkins Symptoms Checklist (SCL-90), the Beck 
Depression Inventory—Short Form, a Locus of Control Scale, and a modified version of 
Rosenberg's Self-Esteem Scale (Fromuth & Burkhart, 1989). The authors also attempted 
to compensate for the confound of family background factors; several researchers have 
noted that the effects attributed to sexual abuse might be, in part, due to family 



25 

background factors (Benedict & Zautra, 1993; Faller, 1989; Johnson & Shrier, 1985; 
Lindholm & Willey, 1986; Myers, 1989, Roland et al., 1989; Violato & Genuis, 1993; 
Yama, Tovey, & Fogas, 1993). Fromuth and Burkhart included Fromuth's Parental 
Support Scale and Parental Bonding Instrument (Fromuth, 1986; Parker, Tupling, &. 
Brown, 1979). 

Most of the men did not perceive their experiences as negative (Fromuth & 
Burkhart, 1989). Interestingly, in spite of this report, many sexually abused men were 
less well adjusted psychologically than non-abused comparisons (Fromuth & Burkhart, 
1989). Men reporting sexual abuse also reported a higher incidence of difficulties 
achieving and maintaining an erection, as well as problems with premature ejaculation 
(Fromuth & Burkhart, 1989). In addition, the authors found a discrepancy between their 
midwestern sample and their southeastern sample; a history of childhood sexual abuse 
was not related to psychological adjustment in the southeastern sample. This finding 
could not be explained by differences in the nature of abuse, culture, or region of the two 
groups; this illustrates the dependence of findings on characteristics of the sample. The 
authors conclude that their finding of a relationship between sexual abuse and later 
psychological fijnctioning is consistent with studies involving females (Alexander & 
Lupfer, 1987; Briere&Runtz, 1988). 

Reporting Abuse 

Many clinicians have wondered if the impact of sexual abuse on boys differs from 
that of girls. There is a common presumption that sexual abuse of boys is most often 
initiated by the child and that boys are less negatively affected by the abusive experience 



26 

(Metcalfe et al., 1990). On the opposite end of the spectrum, it is suggested that the 
response of boys to sexual abuse would differ from girls because boys are less likely to be 
abused by family members and must deal with fears of homosexuality (Finkelhor, 1990). 
The general view of the male perpetrator and female victim often makes it difficult for 
male victims of sexual abuse to report such an event; this theory is often used to explain 
the discrepancies between incidence rates for males and females. Pierce and Pierce 
(1985) note that, while more than Ukely there are fewer father-son/male perpetrator 
(homosexual child abuse) and mother-son/female perpetrator encounters, fears of the 
male victim being identified as homosexual and of being exposed as vulnerable lead to 
both the male victim and others knowledgeable of the male victim's plight to not report 
such abuse. Thus, societal notions lead to the naive assumption this type of child sexual 
abuse never occurs. 

Comparison of Male and Female Abuse 
Defining Abuse 

Another difficulty in identifying male victims of child sexual abuse is the 
difference in which abuse is defined based on gender. Different agencies (medical, legal, 
etc.) as well as different researchers define sexual abuse with different criteria. For 
example, some studies, when examining sexual abuse of females, define abuse as 
"aggravated rape, sodomy, vaginal penetration, fondling, etc." (Fromuth & Burkhart, 
1987; Johnson & Shrier, 1985; Pierce & Pierce, 1985). Such definitions do not always 
apply to male victims, for obvious reasons, but also for more subtle reasons. For 
example, a definition requiring penetration does not take into account sexually 



*..; \/^( I , 



» , . •. .*• A 



27 
stimulating behaviors such as a mother who continues to bathe, dress, or sleep with her 
adolescent son (Pierce & Pierce, 1985). Such behaviors stop short of intercourse, making 
it unlikely to be reported as child sexual abuse; however, there may be significant 
consequences on the son's sexual development (Pierce & Pierce, 1985). 

Symptoms 

Mental health clinics and treatment facilities have particularly large numbers of 
clients who report histories of sexual abuse, both males and females (Hernandez et al., 
1993). One in five men in sexually transmitted disease clinics reports histories of sexual 
abuse (Hernandez et al., 1993). Psychiatric populations have found the prevalence to be 
much higher (Hernandez et al., 1993). Several recent studies have focused on clinical 
samples of boys with histories of sexual abuse. Findings include that most of the 
perpetrators were related to the victims, consistent with childhood sexual abuse of girls; 
the most common form of abuse of males was attempted or completed anal penetration; 
and both boys and girls sexually abused in childhood exhibited increased depression, sex- 
behavior problems, aggression, and hopelessness compared to non-abused, non-clinical 
peers (Violato & Genuis, 1993). 

Pierce and Pierce (1985) reviewed cases of child sexual abuse reported to an 
abuse hotline for a four-year period, encompassing 304 subjects. They examined several 
variables which they believed were related to the abuse, including perpetrator variables, 
variables that sustained the abuse, and differences between male and female victims. 
Specific findings of their study include the sexually abused male was significantly 
younger than the sexually abused female [mean age (male =^ 8.6), (female = 10.6)], 32% 



28 

of the males were African- American, 44% of male victims came from homes with four or 
more children present, and only 4% of male victims compared to 20% of female victims 
were removed from the home as a precaution against further abuse (Pierce & Pierce, 
1985). The authors suggested that this last finding indicated protective services biases 
toward not viewing males as vulnerable to continued sexual abuse. In addition, the 
authors found a significant difference in family composition. Thirty-eight percent of the 
males had no father figure in the home compared to 12%) of the females, and only 24%) of 
the male victims versus 58%o of the female victims lived with their natural fathers (Pierce 
& Pierce, 1985). 

In Pierce and Pierce's (1985) sample, all of the perpetrators were family members, 
relatives, or caretakers. Males were more likely to be abused by stepfathers than females, 
but females were more likely to be abused by their natural fathers than males. Males 
were also more likely to live with their natural mothers and to have no father in the home. 
Perpetrators also most often engaged in oral intercourse with males (52%) of the cases) 
than with females (17%) of the cases), masturbation of males (40%) males vs. 21%) 
females), and fondling was more prominent with females than with males (63%o vs. 32%), 
respectively) (Pierce & Pierce, 1985). Finally, the perpetrators engaged in three or more 
kinds of sexual activity with most of the male children (92%)), which was almost twice as 
often for females who experienced multiple sexual acts (48%)) (Pierce & Pierce, 1985). 

The emotional and physical health of the non-perpetrating parent contributed 
significantly to differences in abuse of males and females. Persons who abused females 
were judged more often to be alcoholic as well as less often emotionally ill than those 
who abused male children (Pierce & Pierce, 1985). The use offeree or threats was found 



29 

to occur significantly more for males than females; of the males, 45% felt forced and 43% 
felt threatened, as compared to 35% of females felt forced and 30% felt threatened. 
Interestingly, males were less likely to see the perpetrator as a tyrant than females (Pierce 
& Pierce, 1985). 

The authors conclude that one difference between male and female child sexual 
abuse is that society tends to blame the abuser if the victim is a male, while the female 
victim is viewed as seductive and inviting of the abuse (Pierce & Pierce, 1985). Also, the 
authors suggest that given the large number of abused males that lived in a home with a 
mother and no father, males were more psychologically vulnerable because of their need 
and desire for a male role model. It was hypothesized that sexually abused males may be 
afraid to refuse sexual advances of relatives or friends because they might then have no 
one to care about them. Mothers of the abused males were also seen as more emotionally 
disturbed, suggesting less emotional support for the abused child. 

Racial Issues 
Just as there is conflict of the similarity and dissimilarity of symptoms between 
male and female victims of sexual abuse, there is conflict over the role race and ethnicity 
plays in sexual abuse. Mennen (1995) argues that a child's cultural group influences the 
values and norms the child develops, characteristic coping and defensive styles, and 
views toward and the meaning given to life events. Thus, a person's racial or ethnic 
background affects attitudes about what constitutes acceptable sexual behavior and may 
influence the way the experience of sexual abuse is processed, the meaning attributed to 
the abuse, and the severity and types of symptoms that may develop following the abuse. 



30 

Mennen (1995) cites several studies that have found racial or ethnic differences in the 
symptoms related to sexual abuse, but notes that findings remain conflicting and 
inconclusive. 

While there has been an increase in attention to examining sexual abuse issues in 
terms of males, there has been little improvement in investigation of the relationship 
between race and sexual abuse. Many researchers put forth the idea that abuse is equally 
prevalent across socioeconomic levels; this may be true. However, when other variables 
such as race, family structure, and physical and mental heahh are factored in, children 
from lower socioeconomic environments show an increased likelihood of experiencing 
sexual abuse. Children from low socioeconomic environments and single-parent homes 
are more frequently targeted for abuse, as are children with physical, neurological, or 
emotional problems (Hernandez et al., 1993). This suggests that African-American 
children, especially African- American males, are at higher risk of sexual abuse compared 
with other groups of children (Hernandez et al., 1993). Demographics indicate that 
African- American males are over-represented in such situations as above; however, there 
is scant research on this population or other ethnic minorities. 

Priest (1992) specifically examined the prevalence of childhood sexual 
victimization and subsequent utilization of mental health services in a selected sample of 
African- American college students. He relied on Finkelhor's (1979) child sexual 
victimization questionnaire, an instrument previously discussed and widely used in 
studies of sexual abuse. Fifteen-hundred students at 12 of the 110 historically African- 
American colleges and universities were randomly selected; a total of 1040 of these 
questionnaires were included in the study. Twenty-five percent of the female respondents 



31 

and 12% of the male respondents reported that they had been sexually abused before age 
17 (Priest, 1992). Of the female victims of sexual abuse, only 19% of them received 
mental health treatment following the abuse, and none of the males had received any form 
of counseling (Priest, 1992). 

Lindholm and Willey (1986) analyzed 4132 cases of child abuse that were 
reported to the Los Angeles Sheriffs Department in order to examine possible ethnic 
differences in child abuse and sexual abuse. Of the cases involving sexual abuse, 95% of 
them involved female victims (Lindholm & Willey, 1986). When the dimension of 
ethnic group was added, the authors found that for their sample, African- American 
children were less likely to be sexually abused than Caucasian or Hispanic children 
(Lindholm & Willey, 1986). Fewer Caucasian females had to participate in sexual 
intercourse compared to Hispanic and African-American females, and oral copulation 
occurred more frequently with Caucasian children than with Hispanic and African- 
American children. Sodomy was generally rare, but Hispanic boys were slightly more 
likely to have been sodomized than Caucasian boys, and African-American boys did not 
report sodomy at all in those cases reporting sexual abuse (Lindholm & Willey, 1986). 
The authors also discovered that 95% of the perpetrators of sexual abuse were male and 
5% were female (Lindholm & Willey, 1 986). 

Lindholm and Willey (1986) conclude that there are significant ethnic differences 
in many aspects of child abuse, and those differences may reflect the variation in family 
structure and child rearing attitudes. Fathers were most often the suspects in Anglo and 
Hispanic families where sexual abuse was investigated, but mothers were the 
predominant suspects in African-American families where sexual abuse was investigated. 



32 

Female suspects were two-to-three times more likely to be single parents than male 
suspects. In addition, many of the reported cases of abuse involved an adult perpetrator 
who was "standing in" for a parent (such as a stepparent, common-law parent, 
boy/girlfriend of the mother/father). Hispanic families showed the greatest concern for 
physical injury and sexual abuse, while African-Americans showed the greatest tendency 
to use objects in whippings or beatings as a form of punishment (Lindholm & Willey, 
1986). The authors conclude that there are many significant differences in types of abuse 
observed based on ethnicity, and that such factors must be examined in attempts to 
understand factors that promote abuse of children, 

Mennen (1995) found that in a sample of Hispanic females, girls who experienced 
vaginal penetration as part of the sexual abuse had mean scores greater than one standard 
deviation of the standardization samples on measures of depression and anxiety. In 
contrast, Hispanic girls who were sexually abused but did not experience vaginal 
penetration produced mean scores closer to the mean of the standardization sample. 
Mennen (1995) notes that there was little discrepancy in scores of Caucasian and African 
American girls on measures of depression and anxiety based on the type of abuse. He 
concludes that the traditional emphasis on purity and the importance of virginity for 
Latinas may lead to the differences for Hispanic girls based on the type of sexual abuse 
(Mennen, 1995). Hispanic girls that experience penetration during sexual abuse may 
have the trauma of sexual abuse compounded by their perceived loss of virginity, and this 
could increase their feelings of worthlessness. 

The amount of information about sexual abuse in Asian populations is almost 
negligible. Rao, DiClemente, and Ponton (1992) examined distinguishing features of 



33 

sexual abuse in Asian populations through retrospective chart reviews. Several 
significant findings resulted from this approach. First, Asian victims were on average 
older than their Caucasian, African- American, and Hispanic counterparts (Rao et al., 
1992). The fact that Asian children were older may explain another finding: that Asian 
victims experienced less physically invasive sexual abuse than other ethnic groups (Rao 
et al., 1992). A significant number of the Asian victims and their families were 
immigrants, and they were more likely than other groups to be living with both parents 
(Rao et al., 1992). A male relative was more likely to be the perpetrator of sexual abuse 
in the Asian cases, and this may be due to the fact that the perpetrator was also more 
likely to be living with the victim's family at the time of the abuse (Rao et al., 1992). 
There were also significant differences in symptomatology following sexual abuse based 
on racial and ethnic differences. Asian victims were less likely than other ethnic groups 
to express anger and hostility but most likely to express suicidal impulses (Rao et al., 
1992). The authors speculated that the reason for this finding is related to cultural 
pressures within Asian communities to not express hostility openly and to internalize 
severe conflicts (Rao et al., 1992). Asian family members were least supportive to the 
victim of sexual abuse. Asian families were least likely to report the abuse, to refer the 
victim to authorities, to believe the abuse occurred, and to be involved in the evaluation 
and treatment process (Rao et al., 1992). Following this, Asian victims of sexual abuse 
were less likely to disclose abuse to such family members as compared to other ethnic 
and racial groups (Rao et al., 1992). 

Rao et al. (1992) also found that Hispanic children were similar to Asians in 
several ways. Hispanic children were also older than Caucasian and African-American 



34 

children when abused, and they were also more likely to be living with their assailant at 
the time of the abuse (Rao et al., 1992). The authors suggest that such factors as 
immigration status, parental marital status, and cultural expectations help explain some of 
the differences between Asian/Hispanic children and Caucasian/ African- American 
children. African-American victims in their sample tended to the youngest victims, were 
the least likely to come from intact families, were least likely to be victims of interracial 
abuse, and suffered more physically invasive forms of sexual abuse (Rao et al., 1992). 



CHAPTER 3 
MATERIALS AND METHODS 

Proposal 

Based on the above review of the literature, research is proposed to investigate the 
relationship between childhood sexual experiences and adult male psychological 
adjustment. In this study, sexual abuse will be broadly defined to include non-contact 
encounters to contact encounters (e.g., exposure to another's genitalia to penetration). 
Furthermore, both coercive and non-coercive events will be defined as sexual abuse; that 
is, a requirement that the sexual contact be unwanted is not part of the definition. There 
is some indication that this distinction may account for many of the discrepant findings 
across studies in terms of symptoms following abuse, the effect of perpetrator gender on 
male victim outcome, and the relationship of race and ethnicity to sexual abuse of males 
(Finkelhor, 1979; Fromuth & Burkhart, 1987; Hernandez et al., 1993). 

In order to exclude cases of age-appropriate sexual experimentation among peers, 
an age criterion will also be employed. Specifically, if the subject was 12 years old or 
younger at the time of the abuse, the older partner had to be at least 16 years old and at 
least 5 years older than the subject; if the subject was between the ages of 13 and 16 at the 
time of abuse, the partner had to be at least 10 years older than the subject (Finkelhor, 



35 



36 

1979; Fromuth & Burkhart, 1987, 1989). This definition has been used in several studies 
cited above and will allow for more generalizability of these findings. In addition, there 
is some speculation of a differential outcome based on age at time of abuse (latency vs. 
post-latency), with some suggestion that adolescent males have a greater tendency to seek 
out sexual experiences with older partners while younger children have sexual 
experiences thrust upon them (Briere & Runtz, 1988; Faller, 1989; Fromuth, 1986; 
Fromuth & Burkhart, 1987; Gilgun & Reiser, 1990; Goflf, 1987; Johnson & Shrier, 1985; 
Krug, 1989; Peluso & Putnam, 1996; Watkins & Bentovim, 1992). 

Hypotheses to be Investigated 
Hypothesis I 

The primary question of interest is the relationship between reported childhood 
sexual abuse experiences and aduh male psychological adjustment. It is hypothesized 
that men who report sexual experiences consistent with this study's definition of abuse 
will be less well-adjusted psychologically compared to men who do not report such 
experiences as measured by mean T-score elevations of the three global indices on the 
SCL-90-R. Specifically, men who report experiences of childhood sexual abuse should 
endorse significantly greater number of items and at greater intensity than non-abused 
comparisons as measured by the Global Severity Index (GSI), the Positive Symptom 
Distress Index (PSDI), and the Positive Symptom Total (PST). 

Surrey, Swett, Michaels, and Levin (1990) examined 140 women outpatients who 
reported a history of sexual or physical abuse, both or no abuse. The authors 
hypothesized that female outpatients would have high rates of reported abuse but lower 



,, 37 

than an inpatient population; that the severity of overall symptomatology would be 
greater for outpatients with a history of abuse compared to non-abused peers; that the 
patterning of symptoms and diagnosis could be used to identify patients with a reported 
history of abuse (Surrey et al., 1990). 

Eighty-nine of the women (64%) reported a history of abuse. Seventeen (12%) 
reported sexual abuse only, 37 (26%) reported physical abuse only, 35 (25%) reported 
both types of abuse, and 51 (36%) reported no history of abuse (Surrey et al., 1990). Of 
the 76 women who reported the age at which they were first abused, 56 (74%) reported 
that it was prior to age 18; 12 (16%) reported sexual abuse only, and 28 (37%) reported 
physical abuse only, and 28 (37%) reported both types of abuse early. Seven (23%) of the 
30 patients reporting early sexual abuse also reported later sexual abuse, and 18 (53%) of 
the 34 patients reporting early physical abuse reported later physical abuse (Surrey et al., 
1990). 

Of the 17 patients reporting sexual abuse, 15 identified their abuser as a friend (4), 
father (3), other family member (3), stranger (3), an authority figure (1) or an unspecified 
person (1). All of the 37 patients reporting physical abuse identified their abuser as either 
a father (1 1), spouse (9), mother (6), brother (5), stranger (3), fiiend (2), and other family 
member (1). Of the 35 patients reporting both physical and sexual abuse, only 32 
indicated the nature of their relationship to the abuser as father (12), stranger (7), brother 
(3), friend (3), mother (2), sister (2), uncle (1), spouse (1), or a person in authority (1). 

The authors found that results of a one-way ANOVA for the Global Severity 
Index (GSI) of the SCL-90 were statistically significant when scores for four categories of 



38 

abuse history were compared (physical, sexual, physical and sexual, no abuse). The 

means for patients reporting one or both types of abuse were significantly higher than 
those reporting no abuse (Surrey et al, 1990). The result of a one-way ANOVA on the 
GSI for first abuse prior to age 1 8 or no abuse was also statistically significant, with 
patients reporting one or both forms of abuse having higher mean scores than those 
reporting none (Surrey et al., 1990), A probit regression analysis carried out determined 
that the GSI score of the SCL-90-R could correctly identify 68% of the patients with a 
reported history of abuse (Surrey et al., 1990). A stepwise multiple regression analysis 
using physical abuse and sexual abuse as the independent variables and GSI as the 
dependent variable revealed that while physical and sexual abuse were significant factors 
in predicting scores, abuse accounted for only 7% of the variance measured by the 
coefficient of multiple determination. This finding suggests that other unknown factors 
contributed/affected the scores. 

In a similar study, Swett, Surrey and Cohen (1990) surveyed an adult male 
psychiatric outpatient population. The authors investigated the relationship between 
physical and/or sexual abuse of males and their current adult functioning. Again, it was 
hypothesized that there would be a higher percentage of the psychiatric population 
reporting abuse histories as well as a higher level of symptoms compared to non-abused 
men (Swett et al., 1990). 

A total of 125 men were surveyed; the majority of subjects were Caucasian, 
single, employed or in college, with a mean age of 37.1 years. Sixty of the subjects 
(48%) reported some history of abuse during their life. Nine (7%) reported sexual abuse 



39 

only, 44 (35%) reported physical abuse only, seven (6%) reported both types of abuse, 
and 65 (52%) reported no history of abuse (Swett et al., 1990). Of the 53 men who 
reported age at time of first abuse, 45 (85%)) reported that abuse was prior to age 18. 
Seven (13%)) reported sexual abuse only, 34 (64%) reported physical abuse only, and four 
(8%) reported both types of abuse. The nine patients with histories of sexual abuse only 
identified their abuser as a friend (2), brother, uncle, authority figure, other person, or 
stranger (1 each), and some other family member (2). 

Similar to the study with female outpatients, a one-way ANOVA found there were 
significant differences in SCL-90-R mean Global Severity Index (GSI) T-scores when 
scores for the four categories of abuse history were compared (physical, sexual, physical 
and sexual, no abuse). The means for patients reporting one or both types of abuse were 
significantly higher than those reporting no abuse (Swett et al., 1990). Of the subjects 
who reported abuse prior to age 18, results of a one-way ANOVA revealed that such 
patients had statistically significant higher scores on five of the subscales and the GSI 
(Swett et al., 1990). Thirty-two subjects reported some form of abuse prior to age 12 and 
one-way ANOVA showed the same trend toward higher SCL-90-R scores for those who 
reported some form of abuse compared to subjects with no history of abuse. Results of a 
two-way ANOVA with the two types of abuse as independent variables and the SCL-90- 
R scale scores as dependent variables were not significant, indicating that there was no 
interaction effect (Swett et al., 1990). A probit regression analysis revealed that the GSI 
of the SCL-90-R could correctly identify subjects with histories of abuse in 68%) of the 
subjects (Swett et al, 1990). A stepwise multiple regression analysis using physical and 



40 

sexual abuse as the independent variables and the SCL-90-R GSI as the dependent 
variable revealed that physical and sexual abuse were significant factors in predicting 
scores. However, abuse accounted for only 15% of the variance according to the 
coefficient of multiple determination, suggesting that other unknown factors also were 
important (Swett et al., 1990). 

Hypothesis II 

A second hypothesis is that of the men who meet this study's criteria for 
experiencing sexual abuse, there will be a significant difference in mean scale GSI 
elevations on the SCL-90-R based on family/parental support, but not based on gender 
and/or relationship of the perpetrator to the male subject. That is, subjects who report a 
sexual experience with an older partner as well as lower ratings of parental support will 
have higher levels of distress as measured by the SCL-90-R GSI, regardless of the gender 
of the older partner or the relationship of the partner to them. The findings of the Roland 
et al. (1989) study support investigation of differences based on role of the perpetrator for 
abuse of females; however, research of male sexual abuse has not resulted in a distinct 
outcome based on the gender or role of the abuser (Johnson & Shrier, 1987; Krug, 1989; 
Pierce & Pierce, 1985, Faller, 1989, Fromuth & Burkhart, 1989). Males who are sexually 
abused appear to consistently struggle with fears of homosexuality and low self-esteem, 
regardless of the gender of the perpetrator (Johnson & Shrier, 1987; Pierce & Pierce, 
1985; Faller, 1989). 



_.....-, . 41 

Hypothesis III ■ . , 

A third question to be investigated in this study is the relationship of age at time 

of abuse and adult male psychological adjustment. It is hypothesized that there will be no 

significant difference in mean scale elevations on the SCL-90-R between subjects who 

report sexual abuse prior to age 12 and subjects who report sexual abuse following age 

12. That is, there should be no discernable difference in adult psychological adjustment 

based on age of abuse, as measured by mean scale elevations on the SCL-90-R. Again, 

there are inconsistent findings regarding the impact of abuse at various ages. Some 

studies suggest that abuse of younger children creates more severe and long-lasting 

problems (Hernandez et al., 1989), while others suggest that abuse of older children is 

more detrimental to psychological adjustment (McLaren & Brown, 1989). 

Hypothesis IV 

Finally, it is predicted that there will be a significant difference in abuse status 
related to the racial/ethnic background of the subjects. That is, minority subjects will 
have a greater frequency of abuse compared to non-minority (Caucasian) subjects. As 
reviewed above, while all forms of abuse occur over the spectrum of socioeconomic 
levels, additional factors such as racial and ethnic background may increase the chances 
of having a history of sexual abuse. As previously discussed, differences in abuse 
patterns by race have been noted in the literature (Hernandez et al., 1993; Mennen, 1994; 
Mennen, 1995, Priest, 1992). ^ 






42 

Subjects 

Subjects consisted of college males (N = 164) from a state university representing 
suburban and rural north-central Florida. Data were collected at five occasions over a 20 
month period between April 1996 and December 1997. Potential subjects were recruited 
through the research subject pool program organized by that university's undergraduate 
psychology program. In this program, students in psychology classes are required to 
participate in psychological research in order to receive necessary academic credits. At 
the time that subjects signed up to participate in this research project, they were simply 
informed of the project identification number and the number of credits offered; they did 
not have prior knowledge of the nature of the research. At the time that subjects met to 
complete the test materials, they were not informed of the nature of the study; that is, they 
were not told that one area of the study was to explore the issue of child sexual abuse. 
Research assistants conducted most data collection sessions after several training 
sessions. Subjects completed the testing session in a small group format with no more 
than 10 subjects per group. All questionnaires (the demographic questionnaire, the 
Sexual History Questionnaire, and the SCL-90-R) were number coded, with each 
individual subject's questionnaires having the same number code. Each subject was 
instructed not to place any identifying information such as their name or social security 
number on any of the forms. When subjects completed the questionnaires, they were 
directed to place all materials in an unmarked manilla envelope and place it in a pile for 
the research assistants. 

Following completion of the study and review of the database, 34 subjects were 
removed from the data pool due to multiple incomplete data points, reducing the total 



43 

sample by almost 21% (N = 130). Criteria for removal from the database were one or 
more of the following: 

1) failure to complete the demographic questionnaire or 

2) failure to complete one or more of the 4 sections of the Sexual History 
Questionnaire or 

3) omission of 1 8 or more items from the SCL-90-R. 

Subjects ranged in age from 17 to 47, but predominately between ages 18 and 20; 
one subject was an outlier at age 47 and increased the variance sevenfold. When this 
subject is removed from the data, mean age was 1 8.73 (see Table 1). The vast majority 
(72.3%) of subjects were Caucasian (see Table 2). Given the small number of subjects 
who identified as non-Caucasian, race was re-organized as a dichotomous variable, 
Caucasian vs. Non-Caucasian (see Table 3). Thus, slightly more than one quarter of the 
sample was non-Caucasian (27.7%). Reported family income ranged from less than 
$10,000 to $90,000 and higher, with the most frequent family income reported as $90,000 
and higher (see Table 4). 

Measures 
Demographic Questionnaire 

The demographic questionnaire was rationally derived for this study. It employs 
several items from various forms used in the University of Florida Psychology Clinic (See 
Appendix A). The form seeks information regarding subject age, racial/ethnic 
background, family composition, family income, and sexual orientation. 



44 



TABLE 1 
DEMOGRAPHIC INFORMATION: AGE 



AGE 


FREQUENCY 


PERCENT 


17 


1 


.8 


18 


70 


54.3 


19 


34 


26.4 


20 


15 


11.6 


21 


5 


3.9 


22 


4 


3.1 


TOTAL 


129 


100 








MEAN AGE 


18.73 




STANDARD DEVIATION 


1.03 




VARIANCE 


1.06 





II = 129 (1 subject removed due to outlier at age 47) 



TABLE 2 
DEMOGRAPHIC INFORMATION; RACE / ETHNICITY 



R.ACE/ETHNICIT\ 


FREQUENCY 


PERCENT 


.Al'rican-.Ajnerican 


8 


6.2 


Latino/Hispanic (non-Black) 


10 


7.7 


1 Asian/ Asian-American 


16 


12.3 


Cauca.sian 


94 


72.3 


Other 


2 


1.5 


TOTAL 


130 


100 



TABLES 

DEMOGRAPHIC INFORMATION: RACE / ETHNICITY 

(CAUCASIAN & NON-CAUCASIAN) 



==^=:==^^ 


FREQUENCY 


PERCENT 


CAUCASIAN 


94 


72.3 


NON-CAUCASIAN 


36 


27.7 


TOTAL 


130 


100 



45 



TABLE 4 
DEMOGRAPHIC INFORMATION: FAMILY INCOME 




INCOME 


FREQUENCY 


PERCENT 




Under $l(),()(»l 


2 


1.5 


S10,000-S2U,Ot)0 


3 


2.3 


S2(),000 - $30,000 


9 


6.9 


$30,000 - $40,000 


8 


6.2 


$40,000 - $50,000 


13 


10.0 


$50,000 - $60,000 


25 


19.2 


$60,000 - $70,000 


11 


X.5 


$70,000 - $80,000 


13 


10.0 


$S(l.000 - $90,000 


12 


9.2 


$90,000 and above 


34 


26.2 


TOTAL 


130 


100 



Sexual History Questionnaire 

Subjects were asked to complete a self-report research survey questionnaire 
previously used in studies of college students (Fromuth, 1986; Fromuth & Burkhart, 
1987; Fromuth & Burkhart, 1989). The survey questionnaire is an extensive modification 
by Fromuth and Burkhart (1989) of the Sexual Life Events inventory created by David 
Finkelhor (1979), Fromuth's modified version has been used in several studies and 
continues to be used in current research (Benedict & Zautra, 1993; Finkelhor, 1979; 
Fromuth, 1986; Fromuth & Burkhart, 1989; Metcalfe et al., 1993; Yama et al., 1993; 
Fromuth, 10/95). Fromuth's questionnaire includes an extensive survey of childhood 
sexual victimization experiences, as well as items related to family composition and 
functioning and current sexual and psychological adjustment. For the purpose of this 



46 
study, the most current and modified version of Fromuth's survey questionnaire will be 

referred to as the Sexual History Questionnaire (see Appendix B). 

One important aspect of the Sexual History Questionnaire is the objective 
categorization of abuse. A major component of this process is the use of an age criterion. 
The age criterion serves to exclude potential age-appropriate sexual experimentation 
among similar aged peers as well as identify significant discrepancies in age among 
sexual partners. Specifically, if the subject was 12 years old or younger at the time of the 
abuse, the older partner had to be at least 16 years old and at least 5 years older than the 
subject; if the subject was between the ages of 13 and 16 at the time of the abuse, the 
partner had to be at least 1 years older than the subject. 

The use of such an age criterion distinguishes between latency-age sexual 
experiences and adolescent sexual experiences. In more psychodynamic theories of 
psychosexual development, the latency phase (roughly age 7 to 1 2 years) is a period in 
which there is a decrease in the prominence of pre-Oedipal and Oedipal striving in terms 
of both intensity and direction (Cole & Cole, 1989; Gay, 1989; Gleitman, 1987; Lewis, 
1996). The degree of preoccupation with sexual impulses and interests that are explicitly 
connected with the assumption of parental roles is significantly diminished during this 
phase ofdevelopment (Cole & Cole, 1989; Lewis, 1996). Individuals use denial, 
avoidance and repression as ways to manage sexual impulses, and gradually also learn to 
use intellectualization, humor, obsessional interests and sublimation as ways to avoid the 
original impulse and the anxiety attached with sexual longings (Cole &. Cole, 1989; 
Gleitman, 1987). The central threat to the latency-age child is the re-emergence or 
breakthrough of the original sexual and aggressive fantasies of the Oedipal phase. 



particularly when associated with the urge to masturbate (Gay, 1989; Lewis, 1996). 
Sleeping difficulties; nightmares; worries about burglars, bodily harm and death and the 
ease of regression to earlier modes of relating to parents (e.g., struggles over food, self- 
care, household responsibilities) may be some of the behavioral phenomena present when 
a latency-age child is confronted with his sexual impulses (Lewis, 1996). 

Adolescence is typically thought to range from approximately age 1 2 to age 20 
years. It is often described as one of the most dramatic phases of human development, 
marked by profound changes in biological, psychological and social functioning (Cole & 
Cole, 1989; Gleitman, 1987; Lewis, 1996). The early part of adolescence, or pre- 
adolescence, is notable for the individual's renewed interest in anatomical differences and 
masturbation (Cole & Cole, 1989). The next phase of adolescence is usually 
distinguished by the endocrinological and biological processes of puberty, that is, the 
development of primary and secondary sexual characteristics (e.g., hair growth, voice 
changes, menarche, nocturnal emissions) (Cole & Cole, 1989; Lewis, 1996). 
Adolescence often marks a dramatic shift in how children relate to their parents, with 
most often seeking ways to become more independent and autonomous (Cole & Cole, 
1989; Gleitman, 1987; Lewis, 1996). 

Included in Fromuth's sexual experiences survey questionnaire is the Parental 
Support Scale, a 12-item measure developed by Fromuth (1986) to examine perceived 
parental supportiveness. It has been suggested that family background and variables are a 
significant mediating factor in determining the outcome for subjects who had experienced 
childhood sexual abuse (Fromuth, 1986 and Violate & Genuis, 1993). Subjects are asked 
to rate on 5-point scales their agreement or disagreement with each item. Both parents 



48 
are rated separately on each item and then scores are combined to produce a total score. 

Fromuth (1986) found that the scale exhibited good internal consistency (alpha 
coefficient = .90) and correlated in the expected direction with other items related to 
parental supportiveness. The Parental Support Scale correlated with feeling emotionally 
neglected as a child [r(440)=-.51, p<.0001]; with perceiving the parental marriage as 
unhappy [r(438)=-.36, p<,0001]; with reporting being physically abused by father 
[r(448)=-.21, p<.0001]; and with reporting being physically abused by mother [r(446)=- 
.28, p<.0001] (Fromuth, 1986). The Parental Support Scale also was significantly 
correlated with a history of childhood sexual abuse [r(383)--. 15, p<.01] (Fromuth, 1986). 

For all subjects, item 9 of this questionnaire was of specific interest. Item 9 
contains 12 statements which subjects rate their mother and father separately on. Each 
statement is based on a Likert scale, with 1 being "never" and 5 "very often" (see 
Appendix B). 

For subjects who reported having a sexual experience with an older partner (that 
met this study's criteria for an abusive sexual experience) before they were 13 years old 
or after age 13, several items were of interest. Specifically, the subject's age at the time 
of the experience (items 12, 33), their estimate of the partner's age at the time of the 
episode (items 13, 34), the gender of the partner (items 14, 35), how the partner was 
related to them (items 15, 36), what sexual behaviors were engaged in (items 16, 37), 
who started it (items 17, 38), was force used (items 18, 39), the subject's reaction at the 
time of the episode (items 24, 45), the subject's feeling at the time of the experience 
(items 29, 50), and the subject's retrospective view of the effect the episode had on their 
life (items 30, 51) (see Appendix B). 



49 

Finally, several similar items were of interest for subjects who reported engaging 

in a sexual episode with someone much younger than themselves and consistent with this 
study's criteria for a sexually abusive experience. Specifically, how old the subject was 
at the time of the episode (item 54), the age of the younger partner (item 55), the gender 
of the younger person (item 56), how the younger partner was related to the subject (item 
57), the nature of the sexual behavior (item 58), who initiated the sexual episode (item 
59), the use of force (item 60), the subject's reaction at the time of the experience (item 
66), the subject's feeling about the experience (item 71), the subject's assessment of the 
impact on his life (item 72), and the subject's assessment of the impact of the episode on 
their younger partner's life (item 73) (see Appendix B). 

SCL-90-R 

Finally, subjects were asked to complete the Symptom CheckList-90-Revised 
(SCL-90-R). Several studies examining adult female psychological functioning following 
experiences of childhood sexual abuse have used the SCL-90-R (Derogatis, 1994 and 
Surrey et al., 1990). The SCL-90-R is a 90-item self-report symptom inventory designed 
to reflect the psychological symptom patterns of community, medical, and psychiatric 
respondents. It is a measure of current psychological symptom status. The SCL-90-R is 
designed for use with psychiatric patients, medical patients, and individuals in the 
community who are not currently patients, Test-retest reliabilities are superior for the 
SCL-90-R and there do not appear to be any significant practice effects that might bias 
the results of repeated administration (Derogatis, 1994). A sixth grade reading level is 



50 
required to take the SCL-90-R. Each item is rated on a five-point Likert scale (0-4) 

ranging fi-om "Not At All" to "Extremely." 

The SCL-90-R is scored and interpreted in terms of nine primary symptom 
dimensions and three global indices of distress. The primary symptom dimensions 
include the following: Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, 
Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychotism. 
These primary symptom dimensions evolved through a combination of clinical/rational 
and empirical/analytic procedures; each dimension has been empirically verified 
(Derogatis, 1994). The syndromes of the SCL-90-R were selected on the basis of clear 
and consistent definition in the literature so that confijsion about what was being 
measured could be averted (Derogatis, 1994). The authors also required that tangible 
manifestations of each construct be measurable via standard scales, and particularly, that 
they be amenable to the self-report modality (Derogatis, 1994). Finally, each of the 
symptom constructs required empirical confirmation in order to be included in the test 
device. 

The three global indices include Global Severity Index (GSI), Positive Symptom 
Distress Index (PSDI), and Positive Symptom Total (PST). These indices were 
developed to provide more flexibility in the overall assessment of the patient's 
psychopathologic status and to fijrnish summary indices of levels of symptomatology and 
psychological distress. Research supports these three indices as separate aspects of 
psychological disorder (Derogatis, 1994). The fijnction of each of these global measures 
is to communicate in a single score the level or depth of the individual's psychological 
distress. Each measure reflects a somewhat different aspect of psychological distress. 



51 

The Global Severity Index (GSI) is the best single indicator of the current level or 
depth of the disorder (Derogatis, 1994). It combines information concerning the number 
of symptoms reported with the intensity of perceived distress. The GSI is recommended 
as the single summary measure of psychological distress (Derogatis, 1994). 

As reviewed above, both physical and sexual abuse have been linked to 
psychological distress. The SCL-90-R has been used in several studies to examine sexual 
and physical abuse, including studies of abusive parents, abused adolescents and adults 
who report a history of childhood abuse (Derogatis, 1994). Consistent across several 
studies has been lower SCL-90-R scores for non-abused subjects compared to both 
inpatient and outpatient subjects who report a history of physical abuse, sexual abuse, or 
both (Derogatis, 1994). The SCL-90-R has also been used to investigate sexual 
function/dysfunction. Derogatis and Myers (Derogatis, 1 994) reported on a heterogenous 
sample of men and women with sexual dysfunction and found that mean SCL-90-R scale 
scores were elevated into the clinical range. 

Procedures 
Subjects were group administered the protocol containing the three questionnaires 
and the Informed Consent by two research assistants (male and female) trained by a 
graduate student in clinical psychology. Groups ranged in size from 4 to 10 subjects. 
Subjects completed all forms in a classroom setting at their university. All forms were 
number coded and students were informed not to place identifying information on any of 
the forms. Administration time was approximately 45 minutes on average. 



. ■: '>} 



52 

Analyses 

Scoring of the SCL-90-R was done by hand and completed by the primary 
investigator. The process of scoring the SCL-90-R questionnaires revealed 28 missing 
data points randomly dispersed across 19 subjects. The SCL-90-R administration manual 
notes that approximately 20% (<=18) of the items can be omitted randomly from one 
profile without substantially affecting the GSI (Derogatis, 1994). Corrections for missing 
data are made by using the actual number of responses (rather than the total possible 
number of responses) to calculate the index scores. Scores derived using such a method 
are adjusted estimates, but are considered valid if missing responses are sparse and 
distributed randomly. Review of the data suggests that this correction method provided 
valid estimates of the three primary indices of interest (GSI, PSDI, PST). 

Coding of the demographic questionnaire and the Sexual History Questionnaire 
was completed by the primary investigator. Based on this, three areas were of interest 
from the demographic questionnaire and items coded included racial/ethnic background, 
sexual orientation, and family income. Several items were of interest from the Sexual 
History Questionnaire; please refer to Table 2 for a complete list of item numbers and 
questions. 

For clerical purposes, three weeks following the initial scoring of the SCL-90-R, 
the SCL-90-R was re-scored and all discrepancies were accounted for and corrected by 
the primary investigator. Similarly, coding of the demographic and Sexual History 
Questionnaires were matched though analysis of computer printouts and all discrepancies 
were accounted for and corrected by the primary investigator. 



53 
Three areas of statistical analyses were performed using Statistical Package for the 
Social Sciences (SPSS). First, descriptive data regarding the subjects were investigated. 
Following this, Pearson bivariate correlations for the SCL-90-R and Sexual History 
Questionnaire were computed. Third, several T-Tests, Analyses of Covariance and 
Multivariate Analyses of Covariance controlling for family support and age at time of 
abuse were conducted in order to explore mean differences between subjects' responses 
to the SCL-90-R. 



s * 



CHAPTER 4 



RESULTS AND DISCUSSION 



Results 



Descriptive Statistics 



The majority of subjects (n = 106, 81 ,54%) did not report having a sexual 
experience with an older partner either before age 13 or after age 13. Of the subjects who 
did report having a sexual experience with an older partner and consistent with this 
study's definition of sexual abuse, only 15 (1 1.54%) reported experiences before the age 
of 13 and only 9 (6.92%) reported after age 13. (see Table 5). 



TABLE 5 
ABUSE FREQUENCIES: BEFORE AGE 13 AND AFTER AGE 13 





Frequency 


Percent 




Abused : prior age 13 


15 


11.54 




Non-abused : prior age 13 


115 


88.46 




Total 


130 


100 












Abused : after age 13 


9 


6.92 




Non-abused : after age 13 


121 


93.08 




Total 


130 


100 





54 



55 



One subject reported sexual experiences with an older partner both before age 13 
and after age 13. For subjects who reported having a sexual experience with an older 
partner before age 13, the mean age at the time of the experience was 8; the mean age of 
their partner was 19.5. For subjects who reported having a sexual experience with an 
older partner after the age of 13, the mean age was 17, the mean age of their partner was 
24. Slightly more than half the subjects who reported having a sexual experience with an 
older partner before age 1 3 did so with a female partner (n = 10) rather than a male (n = 
4); one subject did not respond to this question. In contrast, all subjects who reported 
having a sexual experience after age 13 with an older partner stated that it was with a 
female (n = 9). 

Most subjects who reported such experiences before age 13 noted their reaction 
was one of interest or pleasure in the sexual episode; however, a small number did note 
experiencing fear at the time of the sexual episode (see Table 6). 





TABLE 6 
ITEM 24 (REACTION AT TIME OF EXPERIENCE): PRE- 13 




perp. gender 


fear 


shock 


surprise 


interest 


pleasure 


total 


male 











3 


1 


4 


female 


3 





1 


2 


4 


10 


total 


3 





1 


5 


5 


14 



n = 14 (1 subject did not respond) 



These same subjects overwhelmingly rated their feelings about the experience as 
neutral to positive at the time it occurred (item 29) and found in retrospect that the 
experience had a neutral to positive impact on their lives (item 30) (see Table 7). 



56 



TABLE 7 
ITEM 29 (HOW DID YOU FEEL ABOUT EXPERIENCE?) 

AND 





positive 


mostly 
positive 


iieutnil 


mostly 
negative 


negative 


Total 


item 29 


5 


1 


7 


I 


1 


15 


item 30 


3 


1 


8 


3 





15 


n=15 















In contrast, the majority of subjects who had sexual experiences with older 
partners after the age of 13 noted their reaction as one of interest and pleasure at the time 
of the episode; only 1 subject noted experiencing fear at the time of the sexual episode 
(see Table 8). 



TABLES 
ITEM 45 (REACTION AT TIME OF EXPERIENCE): POST- 13 



perp. gender 



female 



fear 



shock 



surprise 



mterest 



pleasure 



n = 9 



total 



Also differing from subjects who reported sexual experiences with older partners 
before the age of 13, not one subject who had a similar experience after the age of 13 felt 
negative about the experience or that it had a negative impact on their lives. These 
subjects overwhelmingly rated their feelings about the experience as neutral to positive at 
the time it occurred (item 50) and found in retrospect that the experience had a neutral to 
positive impact on their lives as a whole (item 51) (see Table 9). 



TABLE 9 

ITEM 50 (FEELING ABOUT EXPERIENCE) 

AND 

ITEM 51 (EFFECT OF EXPERIENCE ON LIFE): POST- 13 



57 





positive 


mostly 
positive 


neutral 


mostly 
negative 


negative 


Total 






item 50 


6 


2 


1 








9 




item 51 


2 


2 


5 








9 







n = 9 



A much smaller number of subjects (n - 6, 4.62%) reported experiences in which 
they engaged in sexual behaviors with partners much younger than themselves and 
consistent with this study's definition of abuse. The mean age of subjects who engaged 
in a sexual episode with a younger partner was 14.7, while their partner's mean age was 
8.4. Subjects primarily engaged in sexual activities with younger females (n = 4); one 
subject did not respond to this question. Most subjects described their reaction at the 
time of the sexual episode as one of interest (n = 3) or pleasure (n = 2); only 1 subject 
reported experiencing fear at the time they engaged in a sexual episode with a younger 
partner. 

Most subjects reported the experience as pleasurable for themselves at the time 
(item 71), Their assessment of the impact of the sexual episode on the other person was 
that it was a neutral to mostly positive experience for the younger partner (item 72). In 
contrast to this, in retrospect they felt the sexual episode with a younger partner had either 
no impact or mostly negative impact on them (item 73) (see Table 10). 



58 



TABLE 10 

ITEM 71 (HOW DID YOU FEEL ABOUT EXPERIENCE) 

ITEM 72 (EFFECT ON YOUR LIFE) 

ITEM 73 (EFFECT ON YOUNGER PARTNERS LIFE): PERPETRATORS 





positive 


mostly 
positive 


neutral 


mostl> 
negative 


negative 


Total 




item 71 








3 


2 





5 




item 72 








3 


2 





5 


item 73 





1 


4 








5 



n = 5 (1 subject did not respond) 



Finally, mean GSI t-scores were not clinically significant, regardless of subject 
groupings (see Table 11). 



TABLE 1 1 
MEAN GSI T-SCORES (PER GROUP) 





Mean GSI T-score 


Standard Deviation 


N 


Abused 


58.74 


10.88 


23 


Non-Abused 


57.06 


10.58 


107 










Abused : prior age 13 


60.00 


10.91 


15 


Non-abused ; prior age 13 


57.01 


10.57 


115 










Abused : post 13 


57.67 


11.14 


9 


Non-abused : post 13 


57.33 


10.62 


121 










Perpetrator 


61.67 


8.07 


6 


Non Perpetrator 


57.15 


10.7 


124 










Wliolc Sample 


57.35 


10.61 


130 



59 
Correlations • 

Pearson product-moment correlation coefficients were computed for SCL-90-R 
indices (GSI, PSD, PST). Of the three possible correlations between the SCL-90-R 
indices, all three were found to be significantly and positively related to one another (see 
Table 12). 

TABLE 12 
PEARSON PRODUCT-MOMENT CORRELATION COEFFICIENTS ;SCL-90-R 

PSDI PST 





GSI 


GSI 


1.000 




p = - 


PSDI 


.534** 




p = .000 


PST 


.902** 




p = .000 



1.000 

p = - 

.436** 1.000 

p = .000 p = . 



N = 130 

** correlation is significant at the 0.01 level (1-tailed) 



It.- i- ft 



The GSI and PST appear to be very highly correlated ( r = .902, p = .000), with 
81% of the variance in PST predicted by the GSI. This suggests the GSI and PST are 
similar measures of the same construct, namely overall level of distress. However, the 
correlation between the GSI and the PSDI was less strong ( r = .534, p = .000), with only 
29% of the variance in the PSDI predicted by the GSI. The PST and PSDI were even less 
related ( r = .436, p = .000), with only 19% of the variance in PSDI scores predicted by 
the PST. Based upon issues of multicollinearity, the GSI was decided upon post-hoc as 
the sole measure of psychological functioning. 

Additional Pearson product-moment correlation calculations found no significant 
statistical relationship between current ratings of mental health on the SCL-90-R (GSI) 



60 
and level of reported parental support = -.073, p = .409, N = 130). This suggests that for 
this sample, there was little relationship between reported closeness with parents and 
ratings of current mental distress. 

In order to examine the relationship between abuse status and perpetration of 
abuse toward others, chi-square tests were performed. Abuse status prior to age 13 
(abused vs. non-abused) was found to be independent of reporting of perpetration of 
sexual abuse (sexual contact with a much younger partner) (chi-square = . 162, p = .687). 
Interestingly, the relationship between abuse status post age 1 3 (abused vs. non-abused) 
was not found to be independent of reporting of perpetration of sexual abuse (chi-square 
= 6.809, p = .009). For this sample, subjects who reported no experiences of sexual abuse 
after the age of 13 exhibited a higher number of sexual experiences with much younger 
partners, consistent with perpetration of sexual abuse. 

T-tests 

Several T-tests were conducted to determine if there were differences between 
subjects who reported sexual experiences consistent with abuse and those who did not. 

Abuse prior age 13 

There was no significant difference between groups (abused vs. non-abused) for 
reported level of current distress (GSI: t(128) = -1.027, p = .306). There was also no 
distinction between abused and non-abused subjects based on their race or ethnicity 
(Race: t(128) = -.516, p = .607), reported level of family income (Income: t(128) = .560, 
p = .576), or feelings of closeness with their parents (Parental Support: t(128) = -1.1 146, 



61 



p = . 1 59). In general, there was no marked distinction between subjects who did or did 
not report sexual experiences with an older partner before the age of 13 in reported 
distress and other demographic information (see Table 13). 



TABLE 13 
T-TEST FOR EQUALITY OF MEANS FOR ABUSED AND NON-ABUSED 

(PRIOR AGE 13) 







ABUSED 


NON- 
ABUSED 


t 


(If 


signiricance 
(2-tailed) 


mean 
difTerence 


GSI 


MEAN 


60.000 


57.009 


-1.027 


128 


.306 


-2.991 




SD 


10.909 


10.570 


























RACE 


MEAN 


1.333 


1.270 


-.516 


128 


.607 


-0.064 




SD 


.488 


.446 


























FAMILY 
INCOME 


MEAN 


6.667 


7.052 


.560 


128 


.576 


.386 




SD 


2.413 


2.520 


























PARENTAL 
SUPPORT 


MEAN 


71.600 


67.609 


-1.146 


128 


.159 


-3.991 




SD 


9.046 


10.407 


























PERP. 


MEAN 


.0667 


.043 


-.400 


128 


.690 


-0.023 




SD 


.258 


.205 











N = 130 
Abused 11= 15 
Non- Abused n = 1 15 



Abuse post age 13 

Similar to subjects younger than 13, examination of sexual experiences after the 
age of 13 found no significant differences between those who did report such experiences 
and those who did not. There was no significant difference between groups (abused vs. 
non-abused) for reported level of current distress (GSI: t(128) = -.091, p = .927). There 



i 

f 
( 


62 
ilso was no distinction between abused and non-abused subjects based on their race or 
jthnicity (Race: t(128) = .377, p = .707), reported level of family income (Income: t(128) 
= -1.236, p = .219), or feelings of closeness with their parents (Parental Support; t(128) = 
-.985, p = .327). In general, there was no marked distinction between subjects who did or 
did not report sexual experiences with an older partner after the age of 13 in reported 
distress and other demographic information (see Table 14). 

TABLE 14 
T-TEST FOR EQUALITY OF MEANS FOR ABUSED AND NON-ABUSED 

(POST-13) 










ABUSED 


NON- 
ABUSED 


t 


df 


significance 
(2-taileil) 


mean 
difference 




GSI 


MEAN 


57.667 


57.331 


-.091 


128 


.927 


-.336 




SD 


11.136 


10.618 


























RACE 


MEAN 


1.222 


1.281 


.377 


128 


.707 


.059 




SD 


.441 


.451 


























FAMILY 
INCOME 


MEAN 


8.000 


6.934 


-1.236 


128 


.219 


-1.066 




SD 


2.646 


2.4S6 


























PARENTAL 
SUPPORT 


MEAN 


71.333 


67.826 


-.985 


128 


.327 


-3.507 




SD 


10.271 


10.311 


























PERP. 


MEAN 


.222 


.033 


-2.660 


128 


.009 


-.189 




SD 


.441 


.180 












N = 130 
\bused 11 = 9 
Von-abused ii = 


121 











63 
Subjects who perpetrated sexual abuse 

Examination of sexual experiences with a much younger partner, consistent with 
this study's definition of sexual abuse, found no significant differences between those 
who did report such experiences and those who did not. There was no significant 
difference between groups (perpetrator vs. non-perpetrator) for reported level of current 
distress (GSI: t(128) = -1.020, p = .310). There was also no distincfion between self- 
reported experiences of sexual abuse perpetration and non-perpetration based on race or 
ethnicity (Race: t(128) = -1.248 , p = .214), reported level of family income (Income: 
t(128) = 1.011, p = .314) or feelings of closeness with their parents (Parental Support: 
t(128) = -0.024, p = .981) In general, there was no significant group difference between 
subjects who did or did not report sexual experiences with much younger partners (see 
Table 15). " ,, 

ANCOVAs 
Hypothesis I 

The relationship between abuse status and ratings of mental distress on the SCL- 
90-R GSI while controlling for family support was initially proposed to be investigated 
through the use of discriminant fianction analysis. However, because the three indices 
originally intended as dependent variables (GSI, PSDI, and PST) are highly correlated, 
only the GSI was used in the analysis, as the best overall indicator of global distress. 
Accordingly, potential group differences in ratings of mental distress (GSI T-scores) for 
abused and non-abused subjects after controlling for perception of parental support were 
tested through a one way analysis of covariance (ANCOVA). 



64 



There was no significant difference in mean GSI T-scores based on abuse status 
(see Table 16). Perceived parental support also had no significant influence on self- 
ratings of current mental health. Thus, this study's first hypothesis was not supported: 
there was no significant difference in mean GSI T-scores based on report of a sexual 
experience in childhood consistent with abuse while controlling for parental support. 



TABLE 15 
T-TEST FOR EQUALITY OF MEANS FOR PERPETRATOR AND NON- 
PERPETRATOR 







PERP. 


NON-PERP. 


t 


df 


significance 
(2-tailed) 


mean 
difference 


GSI 


MEAN 


61.667 


57.145 


-1.020 


128 


.310 


-4.522 




SD 


8.066 


10.699 


























RACE 


ME/VN 


1.500 


1.266 


-1.248 


128 


.214 


-.234 




SD 


.548 


.444 


























FAMILY 
INCOME 


MEAN 


6.000 


7.057 


1.011 


128 


.314 


1.057 




SD 


2.967 


2.480 


























PARENTAL 
SUPPORT 


MEAN 


68.167 


68.065 


-.024 


128 


.981 


-.102 




SD 


7.574 


10.444 











N = 130 

Perpetrator n = 6 
Non-Perpetrator n = 124 



65 



TABLE 16 

HYPOTHESIS I: BETWEEN SUBJECTS (ABUSE STATUS) ANCOVA 

WITH PARENTAL SUPPORT AS CONTINUOUS COVARIATE 







SS 


Df 


MS 


F 


Sig.ofF 


Covariate 




122.135 


1 


122.135 


1.074 


.302 


(Parental 














Support) 














Main Effects 


(Combined) 


200.268 


2 


100.134 


.881 


.417 




Abuse (< 1 3) 


197.847 


1 


197.847 


1.741 


.189 




Abuse (> 13) 


70.688 


1 


70.688 


.622 


.432 


2 -way 


Abuse (<13) 












interactions 


X 
Abuse (> 13) 


85.593 


1 


85.593 


.753 


.387 


Model 




312.891 


4 


78.223 


.688 


.601 


Residual 




14208.833 


125 


113.671 






Total 




14521.723 


129 









a : computed using alpha = .01 

b : R-Squared = .022 (Adjusted R-Squared = -.010) 



Hypotheses II and III 

For subjects who reported an experience of sexual abuse in childhood, the 
relationship of gender of the perpetrator and relationship of the perpetrator to the subject 
was of interest. However, as noted earlier, research suggests that family variables (such 
as perceived parental support) may influence the impact the child's response to the abuse. 
It was hypothesized that men who meet the criteria for sexual abuse would demonstrate 
greater distress as measured by the GSI when the perpetrator was male and a close family 
relative. 

For subjects who reported sexual abuse prior to age 13, a 2 X 4 (Gender of 
Perpetrator X Relationship of Perpetrator) two between group ANCOVA was performed 



66 



on the dependent variable GSI, while controlling for age at the time of abuse and 
perceived parental support (see Table 17). Relationship of Perpetrator to the subject was 
based on Item 1 5 on the Sexual History Questionnaire. Given the small number of 
abused subject per cell, this variable was re-coded as a dichotomous variable (Family vs. 
Non-family). 



TABLE 17 

HYPOTHESES II AND III: 2 X 2 (GENDER X RELATIONSHIP) ANCOVA 

WITH AGE AND PARENTAL SUPPORT AS CONTINUOUS COVARIATES (PRE- 13) 





Type III SS 


Df 


MS 


F 


Sig.ofF 


Observed 
Power" 


Corrected 


355. sgi' 


5 


71.178 


.489 


.777 


.031 


Model 














Intercept 


1045.126 


1 


1045.126 


7.180 


.025 


.353 


Item 12 


4.248 


1 


4.248 


.029 


.868 


.011 


Parental 


41.048 


1 


41.048 


.282 


.608 


.018 


Support 














Item 14 


51.687 


1 


51.687 


.355 


.566 


.020 


Item IS 


31.334 


1 


31.334 


.215 


.654 


.016 


Item 14 

* 


80.102 


1 


80.102 


.550 


.477 


.026 


Item 15 














Error 


1310.109 


9 


145.568 








Total 


55666.000 


15 










Corrected 


1666.000 


14 










Total 















a : computed using alpha = .01 

b : R-Squared = .214 (Adjusted R-Squared = -.223) 



68 



TABLE 18 
CHI-SQUARE TEST OF INDEPENDENCE (RACE X ABUSE STATUS) 





Abused 


Non-Abused 


Total 


Caucasian 


16 


78 


94 


Non-Caucasian 


7 


29 


36 


Total 


23 


107 


130 



Pearson X^(l) = .105. AsjTiip. Sig. (2-sided) = .746 

The observed chi-square value (X^(l) = .105, p = .746) is quite small and 
negligible; therefore, we must fail to reject the null hypothesis. It must be concluded that 
for this sample, race and history of abuse are independent of one another; that is, non- 
Caucasians were not more likely to report experience of abuse compared to their 
Caucasian peers. 



Discussion 
Review of Purpose 

The purpose of this study was to examine the relationship between childhood 
sexual experiences and adult male psychological flinctioning. Specifically, this study 
sought to examine the impact of sexual experiences that subjects had with older partners 
on their later psychological functioning; such experiences would be classified as sexual 
abuse based on the age difference between the partners and the sexualized nature of the 
relationship. 

Much of the literature examining sexual experiences that occur in childhood 
classify sexual relationships between an older male and a younger female as sexual abuse 



67 
Given the small sample size (n = 1 5), power was low and no significant main 
effects, interactions or covariates were discovered. Perpetrators of the sexual experiences 
were primarily female (n = 11), while the distribution of partners was equally distributed 
between family (n = 7) and non-family (n = 8). 

For subjects who reported sexual experiences with an older partner after the age of 
13, all subjects reported having such an experience with an older adult female (n = 9). In 
addition, each subject who reported having a sexual experience with an older adult female 
also indicated that their partner was a non-family member (n = 9). Thus, statistical 
analyses similar to the ones used to examine group differences in reported level of 
distress based on gender of the perpetrator and relationship of the perpetrator to the 
subject could not be conducted. 

Chi- Square 
Hypothesis IV 

Based on review of the literature, it was predicted that non-Caucasians would be 
more likely than Caucasians to report having had a childhood sexual experience with an 
older partner. In order to examine potential differences in reporting of sexual experiences 
consistent with abuse based on issues of race or ethnicity, a chi-square test of 
independence was conducted on the sample (see Table 18). 






■< > V>J< 



69 
and have found that females who report such histories have greater incidences of anxiety, 
depression and a variety of psychiatric disturbances (Briere & Runtz, 1988; Carlin & 
Ward, 1992; Faller, 1989; Finkelhor, 1990; Fromuth, 1986; McLaren & Brown, 1989). 
There have been fewer studies investigating the nature of male childhood sexual 
experiences with older adults, and the research in male child sexual abuse has been less 
conclusive (Finkelhor, 1990; Fromuth & Burkhart, 1987, 1989; Gilgun & Reiser, 1990; 
Goflf, 1990; Johnson & Shrier, 1985; Krug, 1989; Metcalfe et al., 1990; Muehlenhard & 
Cook, 1988, Watkins & Bentovim, 1992). Such research is important, as there is growing 
agreement that a large number of males have a sexual experience with an older partner, 
whether they classify it as abusive in nature or not. Finkelhor (1994) has called a 1985 
Los Angeles Times survey finding that approximately 16% of the general population of 
males have been sexually abused as children as "defensible as the only truly national 
estimate." The current study is consistent with this base rate, as 17.69% of this sample 
reported sexual experiences in childhood that objectively could be classified as sexually 
abusive. 

Current Study Findings 

In general, there was no statistically different reporting of distress related to 
subjects' childhood sexual experiences with older adult partners, regardless of the gender 
of the adult partner. While such subjects did have slightly higher mean T-scores on the 
SCL-90-R global indices of distress (GSI, PST, PSDI), their scores were neither in the 
clinical range of significance (T score = 65 or higher) or significantly different from their 
peers who did not report such sexual experiences wfiile growing up. The effect size of 



70 
0. 16 suggests that whatever group differences exist between subjects who reported sexual 
experiences in childhood with an adult partner and those who did not is of a very small 
magnitude. 

The absence of significant findings in any of the four hypotheses of this study 
suggest that, as measured by the approaches used herein, boys are not significantly 
negatively affected by sexual contact with persons older than themselves. This conclusion 
is borne out by the following results: men who reported boyhood sexual contact with an 
older person did not report greater distress on the GSI than those who reported no such 
contact. Additionally, the age of the child at the time of the contact did not seem to affect 
the level of distress later reported. There were no demonstrable differences in the amount 
of parental support experienced by the boys who had had these sexual experiences; and 
there was no evidence that minorities were any more likely to have experienced this type 
of sexual contact as children than non-minorities. 

The lack of power to test the aforementioned hypothesis was a significant 
limitation in this study. The small overall sample size, further subdivided by the 
groupings of men into subcategories, created a strong possibility of a type II error in the 
study, or missing a difference that did in fact exist in the population. The small sample 
likewise also affected group means used in calculating effect sizes, with an attendant loss 
of statistical power therein as well. The small effect size found in this study coupled with 
the base rate of abuse reported in the 1994 Times study indicates that much more subjects 
would be needed to fully test the hypotheses in this study. 



„ / ^ 71 

Trends 

While no statistically significant differences were found between subjects who 
reported sexual experiences with older partners and those who did not report such 
experiences, several trends did emerge. Subjects who reported having sexual experiences 
with older partners had a mean GSI score that was not significantly different from cohorts 
who did not report such experiences, but was closer to clinical significance as measured 
by the SCL-90-R. These group differences were in the direction originally hypothesized. 
For example, of the 6 subjects who reported sexual experiences with persons younger 
than themselves, the mean GSI score approached clinical significance (n = 6, Mean GSI 
T-score = 61.67, SD = 8.07) and was slightly higher than subjects who did not report a 
sexual experience with a younger person (n = 124, Mean = 57.15, SD = 10.7). 

Fromuth and Burkhart (1987) found a trend based on age at time of abuse: boys 
who were younger than 13 tended to have more neutral response, while after age 13 more 
positive. Similarly, trends observed in this study were that the majority of subjects who 
had sexual experiences before the age of 1 3 felt it had a neutral to mostly negative impact 
on their lives (n = 15; positive = 3, mostly positive = 1, neutral = 8, mostly negative = 3), 
while those whose experiences occurred after age 1 3 were split between neutral to 
positive (n = 9; positive =2, mostly positive = 2, neutral = 5). 

Literature in the area of sexual abuse has also been concerned with the possibility 
that people who are abused will go on to abuse others. Meta-analyses of the literature 
suggest that this is not true; a review by Widom (1989) found that approximately 66% of 
subjects who report extensive physical abuse, sexual abuse, or neglect do not go on to 
abuse children. Results of the current study show little evidence to suggest that boys who 



72 
experience youthful sexual contact with older persons go on to sexually abuse children 
themselves. Of the 15 subjects who reported abusive experience prior to age 13, 1 
reported a sexual experience with a person much younger than themselves and consistent 
with sexual abuse. Similarly, 2 subjects who reported sexual experiences after age 13 
with someone older acknowledged later sexual experiences with persons much younger 
than themselves. 

While it was difficult to find statistically significant evidence of a negative impact 
of childhood sexual experiences with older partners, it may be inaccurate to conclude that 
there was no impact on the subjects and that the experience was totally benign. It is 
known that anxiety is present for women at the time of an abusive situation; male denial 
of this would not preclude anxiety from having an impact on their subsequent sexual or 
emotional development. This is alluded to by slightly higher mean GSI T-scores for 
subjects who reported experiencing a sexual episode with an older partner in childhood, 
regardless of how they viewed the episode. The slight discrepancy between subjects' 
positive perception of the sexual encounter and current ratings of psychological distress is 
consistent with prior studies in which subjects reported childhood experiences consistent 
with sexual abuse, denied a negative impact from it yet revealed higher incidences of 
sexual dysfunction and general distress (Fromuth & Burkhart, 1987, 1989). There are 
several possible factors that influenced this study's findings and may explain the lack of 
significant group differences. Yet, the aforementioned statistical power limitations did 
not allow for an adequate examinafion of this question. The "negative" results in this 
study may, like previous studies, represent the subclinical sequalae of this phenomenon. 



■ ■■■ 73 

However, the most plausible conclusion that can be drawn from this data at this point is 
that the question remains unanswered to any degree of scientific certainty. 

Measurement Issues 

In addition to low statistical power, there are several possible factors that 
influenced this study's findings and may explain the lack of significant group differences. 
Future research in this area would be well served by considering these issues. 

One of the greatest difficulties in studying male sexual abuse is the variation in 
definitions of abuse that exist between studies. Often, differences in how researchers 
define inclusion/exclusion criteria determine the rate of abuse that is found in their 
sample (e.g., non-contact behaviors vs. contact behaviors). Some studies rely strictly on 
the subject's perception of the experience (e.g., was the experience unwanted? Was the 
experience perceived as abusive?). Fromuth and Burkhart's (1987) review of the 
literature suggests that substantial variations in the rates of abuse reported can be found 
even when similar definitions appear to be used. 

In this study, an age criterion was used in order to exclude what may have been 
age-appropriate sexual experimentation among similar aged peers. Specifically, if the 
subject was 12 years old or younger at the time of the abuse, the older partner had to be at 
least 16 years old and at least 5 years older than the subject; if the subject was between 
the ages of 13 and 16 at the time of the abuse, the partner had to be at least 10 years older 
than the subject. This definition of sexual abuse has been used in several studies 
(Finkelhor, 1979; Finkelhor, 1990; Fromuth & Burkhart, 1987; Fromuth & Burkhart, 



^. 74 

1989) and was used in the hopes of gathering more descriptive data regarding male sexual 
experiences as well as improving cross-study comparison. 

The use of the Sexual History Questionnaire was also felt to improve the 
generalizability of these results. The use of such a questionnaire allowed for an objective 
categorization of subjects and then examination of the relationship between such 
categorization and their perceptions of the experience. 

One explanation for this study's findings is that the measures used (SCL-90-R, 
Sexual History Questionnaire) were too general. The SCL-90-R may not be sensitive to 
picking up more specific sequelae of this type of abuse (e.g., male childhood sexual 
abuse). In addition, the Sexual History Questionnaire reUed on a wide definition of abuse 
in which sexual abuse is defined by a continuum of non-contact encounters (e.g., 
exposure to another's genitalia) as well as contact behaviors (e.g., intercourse). In fact, 
Fromuth and Burkhart (1987) found that the more stringent the definition of abuse used in 
research, the more clearly sexual experiences are identified as being abusive and the more 
similar data appear from study to study. 

Given the differences that arise based on varying definitions of abuse, it is also 
likely that how information regarding male sexual abuse is obtained may determine the 
type of results found. Most studies using college males tend to use a questionnaire 
approach such as the Sexual History Questionnaire (Finkelhor, 1979, 1990; Fromuth & 
Burkhart, 1987; Priest, 1992). Unfortunately, the use of broad, ftinnel-sampling 
techniques appears to define different groups in males and females. Females tend to 
show more similarities between clinical and non-clinical populations with sexual 
experiences consistent with abuse being seen as having more negative impact (Carlin & 



75 
Ward, 1992; Faller, 1989; Fromuth & Burhkhart, 1987; Goldwater & Duffy, 1990). In 
contrast, males reveal more heterogeneity in non-clinical samples using the same methods 
and data from samples of non-clinical male subjects appear very different from studies 
that specifically recruit men who report being sexually abused or men in psychotherapy 
(Fromuth & Burkhart, 1987, Goff", 1990, Muehlenhard & Cooks, 1988; Pierce & Pierce, 
1985). For example, Murphy (as cited in Fromuth and Burkhart, 1987) found that 3% of 
males sampled using a telephone survey had an unwanted sexual contact before age 18. 
In contrast, the current study with college males found 18.46% of the sample (N = 130) 
reported sexual contact with an older partner before age 18. 

The use of paper and pencil questionnaires may also have made subjects more 
reluctant acknowledge experiences that might be considered shameful or embarrassing. 
The use of such a highly complex questionnaire as the Sexual History Questionnaire, 
which relied heavily on the use of contingent questioning, likely contributed to lost data. 
One study of sexual and drug behaviors found significant differences in how subjects 
responded based on the format in which the questions were asked. Males who answered 
questions using an audio computer-assisted self-interviewing (audio-CASI) program were 
almost four times more likely to report having same-gender sexual experiences in 
adolescence, compared to their same-age peers who answered the same questions using a 
paper and pencil questionnaire (Turner, Ku, Rogers, Lindberg, Pleck & Sonenstein, 
1998). Subjects were also less likely to use "I don't know" or "refuse to answer" options 
when using the audio-CASI questionnaire form when compared to responses to the same 
paper and pencil questionnaire form (Turner et al., 1998). The use of the computerized 
questionnaire form may allow participants in research projects to feel more anonymity. 



76 
thus increasing their likelihood to accurately report on more sensitive or particularly 
stigmatizing topics such as male childhood sexual abuse. 

Given the above, the use of the broad definition of sexual abuse used in this study 
likely had a mixed impact on the results. On the one hand, the use of such a definition 
resulted a number of subjects reporting experiences consistent with abuse and with the 
known baseline for male sexual abuse. Use of a more narrow definition, such as 
inclusion of subject's definition of the experience as abusive, would likely have resulted 
in fewer subjects acknowledging such events in their childhood. However, the use of the 
paper and pencil questionnaire format may have made subjects more reluctant to 
acknowledge the negative impact of such experiences. In addition, the SCL-90-R may 
have focused more on general, global behaviors and not been as sensitive to the more 
subtle emotional and dynamic impact of childhood sexual experiences. The use of 
measures that looked at each subject's current relationship style and patterns, conflicts 
and attributions may have found greater differences between groups. 

Another factor which may have influenced the findings is the retrospective nature 
of the study. Subjects were removed in time from the events they reported on, in some 
cases more than a decade. Questioning them in what may be a relatively benign period in 
their lives may have led to less emphasis on the impact of any childhood sexual 
experiences. 

Social Desirability 

There are several societal perceptions and presumptions which contribute to 
difficulties in studying male child sexual abuse. Finkelhor ( 1 979) noted that "a priori 



11 

assumptions involving the presumed nature of sexual abuse with boys, specifically 
presumptions of more self-initiated sexual behavior and less negative impact, may have 
considerable impact on researchers' orientation to investigating this area." 

It is important to note that in the current study, all subjects defined themselves as 
heterosexual. Of the 15 subjects who reported sexual experiences with an older partner 
before the age of 13, only 4 reported experiences with male partners, while all 9 subjects 
who reported sexual experiences with older partners after age 1 3 stated it was with female 
partners. Male sexual socialization encourages men to define sexual experiences as 
desirable as long is there is no homosexual involvement. Thus, given that all of the men 
in the current study defined their sexual orientation as heterosexual and reported sexual 
experiences with older females, it is perhaps not surprising that the men report these 
experiences as relatively non-exploitative and without negative effects. Bancroft's model 
of sexual development suggests that for many males, the self-labeling stage of sexual 
identity development is a critical period in which males consciously examine their 
sexuality (Bancroft, 1989). It is possible that if male subjects in this study did experience 
anxiety at the time of their childhood sexual encounter, the next stage of social labeling 
may have retroactively transformed the experience. That is, the ever present myth that 
"any young man is lucky to have a sexual encounter with an older female" may have 
resuhed in subjects denying their anxiety. In addition, non-sexualized issues may have 
also come into play, such as over-learned sex-typed behavior (e.g., "men are not victims, 
they are aggressors"). "'■ ' %■.■■ i i>^t. 



78 
Unique Sample Characteristics 

A unique characteristic of this sample was the relatively high level of reported 
family income. More than half of the subjects reported a family income of $60,000 (n = 
70), and of those 34 subjects reported family incomes that were $90,000 or greater. It is 
possible that subjects from such social strata felt even more pressure to not reveal 
potentially embarrassing information. These findings are consistent with other studies 
where subjects with reportedly "middle-class" or higher family incomes, often present a 
more mixed and sub-clinical level of symptoms (Fromuth, 1986). One factor which may 
mediate individual response to sexual abuse is family income (Hernandez et al., 1993). 
While it may be true that child sexual abuse is prevalent across all socio-econonomic 
strata, the impact of such experiences may differ based in part on the level of family 
income. Thus, individuals from families with limited financial resources and the various 
life stressors that often accompany lower income may be at increased risk for developing 
more significant pathology in response to childhood sexual experiences. 

College males are often plagued with a muhitude of doubts and fears concerning 
self-esteem, abandonment, bonding, trust, and self-disclosure (Goff, 1990). Young men 
in this age group are particularly sensitive and vulnerable to feelings of inadequacy, 
especially with regards to their own sexuality. Many males, including males who may 
define themselves as homosexual, must grapple with societal views on same sex 
experiences which often includes explicit expectations regarding gender role behavior as 
well as both religious and moral condemnation when such roles are rejected. For many 
college males eager to belong, such a risk of alienation may well influence them to 
conform to societal expectations regarding their gender behavior. This may result in 



■■, - 79 

males masking any behaviors that are not consistent with their idea of masculinity, such 
as displaying emotion, acknowledging weakness, or homosexual desires. 

Such a discrepancy between internal states and projected behavior may explain 
some of the variable findings in studies of male childhood sexual abuse. It may explain 
diflFerences between ratings of sexual experiences and reported anxiety/distress; that is, 
men who report experiences consistent with an abusive sexual episode, deny negative 
impact but still endorse high levels of distress (Fromuth & Burkhart, 1987, 1989). Thus, 
any study of college male sexual experiences must attempt to deal with the confound of 
developmentally appropriate feelings of inadequacy, depression and anxiety that are 
common in many college males as well as the added possibility that subject's are 
reconstructing past childhood experiences to conform to their ideas of gender appropriate 
behavior. • --, \ ? • 



^ 



CHAPTER 5 
SUMMARY AND CONCLUSIONS 

Based on the above findings, it is concluded that for this sample of college males 
sexual experiences while in childhood with an older adult partner had no significant 
negative impact on their later adult functioning. There was little relationship between 
self-reported sexual experiences in childhood and current self-ratings of general mental 
health. While older partners were almost exclusively female, there did not appear to be 
any significant differences in reported mental health based on the gender of the older 
sexual partner. This data does suggest some possible trends, including multiple sexual 
experiences in childhood may have a more negative influence on later psychological 
functioning. This trend would be consistent with research of female sexual abuse. 

The SCL-90-R may not be the most sensitive instrument in examining issues 
related to male sexual abuse with a non-clinical population. Other measures which 
examine more intrapsychic factors such as gender conformity may help in understanding 
such complicated data. For example, the use of the MMPI-2 Masculinity/Femininity 
subscale in conjunction with measures of sexual behavior may provide a better 
understanding of male sexual abuse. Also, measures of subject's sense of control may 
also be helpful in understanding male reaction to sexual abuse; while many reported that 



80 



81 
the older partner initiated a sexual encounter, it was unclear if the subject felt helpless, if 
they felt the other person was in charge and how such perceptions of their own autonomy 
influenced their reaction to the sexual experience. 

While this study did attempt to encourage open and honest reporting by subjects 
through an anonymous data collection process, it is possible that subjects still did not 
respond candidly to the questionnaires. Given that the current study consisted entirely of 
subjects who identified themselves as heterosexual and the predominate belief in a 
heterosexually dominate culture such as ours that sexual experiences with older females 
are "acceptable if not desirable," it is likely that such a powerful societal norm impinged 
on any recollection of anxiety, trepidation or fear. 

These findings reflect the complex interaction of self-reporting, gender identity, 
sexual identity and abuse. This may explain some of the trends found in the data. It was 
hoped that anonymity would improve self-disclosure; while the use of an additional 
interview may have been helpful in clearing up any missing data points, it probably would 
have been more difficult for subjects to speak directly with another person regarding their 
sexual behavior regardless of the nature of such experiences. Given the societal factors 
which increase the likelihood of men not perceiving their sexual experiences in childhood 
as abusive, it may be important to continue to rely on broad funnel-type methodology to 
gain information regarding male sexual experiences and male child sexual abuse. More 
information is needed regarding male sexual abuse and continued use of similar research 
methods may better clarify the nature of this phenomenon. 

The generalizability of this study is somewhat limited by the small, 
nonrepresentative sample size on which it is based. While attempts were made to 



82 
encourage a broad sample of college males, the majority of subjects represented a largely 
homogenous group across racial and socioeconomic variables. Future studies using such 
a questionnaire may benefit from using additional measures which directly question 
subject's regarding their understanding and perception of sexual abuse. While subjects 
generally did not feel that their experiences with an older sexual partner had a negative 
impact on them, their perception of what is considered abusive is uncertain and reliance 
on an age difference to define abusive relationship is not sufficient. 

In conclusion, it is still unknown if there are significant negative emotional 
symptoms for men who were sexually abused as children. This data suggests that 
whatever impact remains in adult life is clinically mild. Yet, the limited sample size and 
mild magnitude of this phenomenon suggest caution in generalizing these findings. 
Replication with a larger sample and more control over previously discussed 
measurement issues may unravel this complex and important puzzle in the fijture. 






APPENDIX A 
DEMOGRAPHIC QUESTIONNAIRE 






DEMOGRAPHIC QUESTIONNAIRE 



I) Age: 

Date of Birth; 



2) Current Marital Status 

a) never-married 

b) engaged 

c) married 

d) separated 

e) divorced 

f) widowed 

3) Racial / Ethnic Identity 

a) African/African-American 

b) Latino/Hispanic (non-Black) 

c) Asian/Asian-American 

d) Caucasian 

e) other (please describe): 



4) What is your religious background?: 

a) CathoUc 

b) Protestant 

c) Baptist 

d) Pentecostal 

e) Jewish r, 

f) Islamic 

g) other (please describe): 



84 



85 



5) How do you define your sexual orientation? 

a) heterosexual 

b) homosexual 

c) bisexual 

d) other (please describe); 



6) How many sisters do you have? 
Please list their ages: 



7) How many brothers do you have? 
Please list their ages: 



8) How many step-/half-sisters do you have? 
Please list their ages: 



9) How many step-/half-brothers do you have? 
Please list their ages: 



10) Please circle your family's yearly income: 

a) Under $10,000 f) $50,000 - $60,000 

b) $10,000 -$20,000 g) $60,000 - $70,000 

c) $20,000 - $30,000 h) $70,000 - $80,000 

d) $30,000 - $40,000 I) $80,000 - $90,000 

e) $40,000 - $50,000 j) $90,000 and above 

1 1) What degree are you expecting to attain in your current program? 



APPENDIX B 
SEXUAL HISTORY QUESTIONNAIRE 



•t a. & .. ■ f :, :. 



PART A 
We would like to gather some information about MEMBERS OF YOUR FAMILY. 

1 . First, about your FATHER. 

a. Is he: 

1 . Living with your mother 

2. Divorced or separated from her 

3. Widowed 

4. Living apart for some other reason 

5. Deceased 

b. Was there any time before you were 16 when you didn't live with him for more than one 
year? 

1. Yes 0. No 

c. When you last lived with him, how close did you feel to him? 

1 . Very close 

2. Close 

3. Somewhat close 

4. Not close 

5. Distant 

2. Did you also have a STEPFATHER? 

1. Yes 0. No 

3. Now about your MOTHER 

a. Is she: 

1 . Living with your father 

2. Divorced or separated from him 

3. Widowed 

4. Living apart for some other reason 

5. Deceased 

b. Was there any time before you were 16 when you did not live with her for more than one 
year? 

1. Yes 0. No 

c. When you last lived with her, how close did you feel to her? 

1. Very close 

2. Close 

3. Somewhat close 

4. Not close 

5. Distant 

4. Did you also have a STEPMOTHER? 

1. Yes 0. No 

5. When you were 12, how would you say your parents' marriage was? 

1 . Unhappy 

2. Not very happy 

3. Somewhat happy 

4. Happy 

5. Very happy 

o / 



88 

When you were 12 did you have: 

1 . Many good friends 

2. A few good friends 

3. One or two good friends 

4. No good friends 

Do you feel you were emotionally neglected as a child? 

1. No, not at all 

2. Yes, mildly neglected 

3. Yes, moderately neglected 

4. Yes, severely neglected 

How would you describe your family life while you were growing up? 

1 . Unhappy 

2. Not very happy 

3. Somewhat happy 

4. Happy 

5. Very happy . - 

Answer the following questions about the set of parents you had when you were 12. If you did not 
live with both parents when you were 12, answer for that parent at some earlier age when you were 
living with him or her. 



Never 
1 



Rarely 
2 



Sometimes 
3 



Often 
4 



Very Often 
5 



How true was this of your father and mother? 



a. Treated you as if you were important 

b. Was verbally abusive of you 

c. Played with you 

d. Was tense, nervous, worried 

e. Was ill 
f Drank heavily 
g. Understood you 
h. Kissed you 
i. Hugged you 

j. Talked to you when you had a problem 
k. Was responsive to your emotional needs 
1. Had emotional problems 

PARTB 
It is now generally realized that most people have sexual experiences as children and while they are still 
growing up. Some of these are with friends and playmates, and some with relatives and family members. 
Some are very upsetting and painftil, and some are not. Some influence people's later lives and sexual 
experiences, and some are practically forgotten. Although these are often important events, very little is 
actually known about them. 

We would like you to try to remember the sexual experiences you had while growing up. By "sexual", we 
mean a broad range of things, anything from playing "doctor", to sexual intercourse - in fact, anything that 
might have seemed "sexual" to you. 





2 


3 


4 


5 


1 2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 




2 


3 


4 


5 


2 


3 


4 


5 



89 



We want you to think of three sexual experiences - or however many up to three - that you had BEFORE 
the age of 13 with someone who was at least 5 years older than you. This might include strangers, friends 
or family members such as cousins, aunts, uncles, brothers, sisters, father or mother. Pick the three most 
important to you and answer the following questions. 

Take one experience and answer all the questions on the three pages that pertain to it, and then return to 
answer the same questions about experience #2 and #3. 
11. No such experience ( ), go to question #32. 

With regard to the first experience: 



Exper. 

#1 



Exper. 

#2 



Exper. 

#3 



12. About how old were you at the time the experience started? 

13. About how old was the other person? (If not sure, please estimate) 

14. Was the other person: 1 for male 

• 2 for female 



15. Was the other person: 

A stranger 

A person you knew, but not a friend 
A friend of yours 
A male friend of your parent(s) 
A female friend of your parent(s) 
A cousin 
An aunt or uncle 
A grandparent 
A brother 
A sister 
A father 
A stepfather 
A mother 
A stepmother 
A teacher 
A boss 



1 


1 


1 


2 


2 


2 


3 


3 


3 


4 


4 


4 


5 


5 


5 


6 


6 


6 


7 


7 


7 


8 


8 


8 


9 


9 


9 


10 


10 


10 


11 


11 


11 


12 


12 


12 


13 


13 


13 


14 


14 


14 


15 


15 


15 


16 


16 


16 



16. What happened? Circle - 1 for Yes 

for No 

a. An invitation or request to do something sexual 

b. Kissing and hugging in a sexual way 

c. Other person showing his/her sexual organs to you 

d. You showing your sex organs to other person 

e. Other person fondling you in a sexual way 
f You fondling other person in a sexual way 
g. Other person touching your sex organs 

h. You touching other person's sex organs 

i. Other person rubbing their genitals against your body 

Oral-genital contact - other person stimulating you 

Oral-genital contact - you stimulating other person 

Anal intercourse 
Intercourse 

Other person took pictures of you while you were naked 

Other, please mention: 



J- 



m. 
n. 

0. 





I 




1 




1 




I 




1 




I 




1 




1 




1 




1 




1 




1 




1 




1 



























1 





1 





1 






90 



17. 



Experience #1 
Experience #2 
Experience #3 



Who started this? 
1. You 



2. Other person 



1 8. Did other person tlireaten or force you? 

2. Yes 1. A little 0. No 

1 9. Did other person try to bribe you with promises, candy, money, etc. 

1. Yes 0. No 

20. Had the other person been drinking or using drugs? 

1. Yes 0. No 

2 1 . Had you been drinking or using drugs? 

1. Yes 0. No 

22. Please estimate how many times you had a sexual experience with 
this person. 

23. Over how long a time did this go on? (Indicate number of days, 
months, years). 

24. Which of these would best describe your reaction at the time 
of the experience? 

1. Fear 4. Interest 

2. Shock 5. Pleasure 

3. Surprise 

25. At the time it happened, who did you tell about this, if anyone? 

1 = YES = NO 

1 . No one 

2. Father 

3. Mother 

4. Other adult 

5. Brother/sister 

6. Friend 

7. Other, please specify 



Exper. 

#1 

1 2 

1 2 



Exper. 

#2 

1 2 
1 2 



Exper. 

#3 

1 2 

1 2 



2 10 2 10 2 10 



10 10 10 



10 10 



10 10 10 



1 

2 
3 
4 
5 



N 



1 
2 
3 
4 
5 



N 



1 

2 
3 
4 
5 



N 



1 








1 








1 








1 








1 








1 















91 




Exper. 


Exper. 


Exper. 




#1 


#2 


#3 


26. 


Did you ever tell anyone about this experience? 








1. Yes 0. No 10 


I 


1 


27, 


Was this experience ever reported to the police? 








1. Yes 0. No 10 


1 


1 


28. 


Have you ever talked to a counselor about this experience? 








1. Yes 0. No 10 


1 


1 


29. 


At the time, how did you feel about the experience? 








1. Positive 1 


1 


1 




2. Mostly positive 2 


2 


2 




3. Neutral 3 


3 


3 




4. Mostly Negative 4 


4 


4 




5. Negative 5 


5 


5 


30. 


In retrospect, what kind of effect did this experience have on your life? 








1. Positive 1 


1 


1 




2. Mostly positive 2 


2 


2 




3. Neutral 3 


3 


3 




4. Mostly Negative 4 


4 


4 




5. Negative 5 


5 


5 


NOW GO BACK TO PAGE 3 AND ANSWER THE QUESTIONS ABOUT OTHER EXPERIENCES. 


IF NO OTHER EXPERIENCES, ANSWER THE FOLLOWING QUESTION AND THEN GO ON TO 


THE NEXT PAGE. 






31. 


Pick one of these experiences and describe how it started. Please use the back of this page to 






write your answer. 






We would like you to think of any sexual experience that occurred to you AFTER the age 


of 12 with 




someone at least five years older than you. ALSO, please report any sexual experience that occurred to 




you, 


regardless of age, which you did not consent to. That is, a sexual experience which was forced on 


you 


or which you didn't want to happen. Do not repeat a relationship which you described earlier. Pick the 




three most important and answer the following questions; take one experience first and answer all the 




quest 


ions; then return to answer the questions on experience #2 and then #3. 






32. 


No such experience ( ), go to question #53. 






With 


regard to experiences AFTER age 12 or that were nonconsentual: 








Exper. 


Exper. 


Exper. 




#1 


#2 


#3 


33. 

34. 


About how old were vou at the time the experience started? 






About how old was the other person? (If not sure, please estimate) 

Was the other person: 1 for male 1 2 






35. 


1 2 


1 2 




2 for female 















92 






Exper. 


Exper. 


Exper. 






#1 


#2 


#3 


36. Was the other person: 










A stranger 




1 


1 


1 


A person you knew, but not a friend 




2 


2 


2 


A friend of yours 




3 


3 


3 


A male friend of your parent(s) 




4 


4 


4 


A female friend of your parent(s) 




5 


5 


5 


A cousin 




6 


6 


6 


An aunt or uncle 




7 


7 


7 


A grandparent 




8 


8 


8 


A brother 




9 


9 


9 


A sister 




10 


10 


10 


A father 




11 


11 


11 


A stepfather 




12 


12 


12 


A mother 




13 


13 


13 


A stepmother 




14 


14 


14 


A teacher 




15 


15 


15 


A boss 




16 


16 


16 


37. What happened? Circle - 1 for YES 










for NO 










a. An invitation or request to do something sexual 







1 


1 


b. Kissing and hugging in a sexual way 







I 


1 


c. Other person showing his/her sexual organs to you 







1 


1 


d. You showing your sex organs to other person 







1 


1 


e. Other person fondling you in a sexual way 







1 


1 


f You fondling other person in a sexual way 










1 


g. Other person touching your sex organs 










1 


h. You touching other person's sex organs 










1 


i. Other person rubbing their genitals against your body 










1 


j. Oral-genital contact - other person stimulating you 










1 


k. Oral-genital contact - you stimulating other person 




1 





1 


1. Anal intercourse 




1 





1 


m. Intercourse 




1 





1 


n. Other person took pictures of you while you were naked 




1 





1 


0. Other, please mention: 










Experience #1 










Experience #2 


Experience #3 


38. Who started this? 










1- You 2. Other person 


1 


2 


1 2 


1 2 




1 


2 


1 2 


1 2 


39. Did other person threaten or force you? 










2. Yes I. A little 0. No 


2 


1 


2 1 


2 1 



93 



40. 



Did other person try to bribe you with promises, candy, money, etc... 



1. Yes 



0. No 



1 


1 


1 


Exper. 


Exper. 


Exper. 


#1 


#2 


#3 



4 1 . Had the other person been drinking or using drugs? 

1. Yes 0. No 



1 



42. Had you been drinking or using drugs? 

1. Yes 0. No 



1 



43. Please estimate how many times you had a sexual experience with 
this person. 

44. Over how long a time did this go on? (Indicate number of days, 
months, years). 

45. Which of these would best describe your reaction at the time 
of the experience? 

1. Fear 4. Interest 

2. Shock 5. Pleasure 

3. Surprise 

46. At the time it happened, who did you tell about this, if anyone? 

1 = YES = NO 

1 . No one 

2. Father 

3. Mother 

4. Other adult 

5. Brother/sister 

6. Friend 

7. Other, please specify 

47. Did you ever tell anyone about this experience? 

1. Yes 0. No 





1 


1 


1 


2 


2 


2 


3 


3 


3 


4 


4 


4 


5 


5 


5 



N 



N 



N 


















































































48. Was this experience ever reported to the police? 

1. Yes 0. No 

49. Have you ever talked to a counselor about this experience? 

1. Yes 0. No 



50. At the time, how did you feel about the experience? 

1. Positive 

2. Mostly positive 

3. Neutral 

4. Mostly Negative 

5. Negative 

51. In retrospect, what kind of effect did this experience have on your life? 

1. Positive 1 

2. Mostly positive 2 

3. Neutral 3 

4. Mostly Negative 4 

5. Negative 5 



1 




1 


1 


2 




2 


2 


3 




3 


3 


4 




4 


4 


5 




5 


5 




1 




1 




2 




2 




3 




3 




4 




4 




5 




5 



94 



NOW GO BACK TO QUESTION #33 AND ANSWER THE QUESTIONS ABOUT OTHER 
EXPERIENCES. IF NO OTHER EXPERIENCES, ANSWER THE FOLLOWING QUESTION AND 
THEN GO ON TO THE NEXT PAGE. 

52. Pick one of these experiences and describe how it started. Please use the back of this page to write 
your answer. 

Finally, we would like you to think of any sexual experience you ever had growing up with someone at least 
5 years younger than you. For example, this would include experiences you had when you were 15 and the 
other person was 10. Pick the three most important to you and answer the following questions. Answer all 
questions for experience #1 first and then return to answer for experiences #2 and #3. 

53. No such experience ( ), go to question #75. 

Exper. # I Exper. #2 Exper. #3 

54. About how old were you at the time the experience started? 



55. 
56. 



About how old was the other person? (If not sure, please estimate) 



Was the other person: 



1 for male 

2 for female 



57. Was the other person: - i 

A stranger 

A person you knew, but not a friend 

A friend of yours 

A male fi"iend of your parent(s) ;• 

A female friend of your parent(s) 

A cousin 

An aunt or uncle 

A grandparent 

A brother ,. 

A sister 

A father 

A stepfather 

A mother 

A stepmother 

A teacher 

A boss 

58. What happened? Circle - 1 for YES or 2 for NO 

a. An invitation or request to do something sexual 

b. Kissing and hugging in a sexual way 

c. Other person showing his/her sexual organs to you 

d. You showing your sex organs to other person 

e. Other person fondling you in a sexual way 
f You fondling other person in a sexual way 
g. Other person touching your sex organs 

h. You touching other person's sex organs 

i. Other person rubbing their genitals against your body 

j. Oral-genital contact - other person stimulating you 

k. Oral-genital contact - you stimulating other person 

I. Anal intercourse 

m. Intercourse 

n. Other person took pictures of you while you were naked 

0. Other, please mention: 



1 




1 




1 


2 




2 




2 


3 




3 




3 


4 




4 




4 


5 




5 




5 


6 




6 




6 


7 




7 




7 


8 




8 




8 


9 




9 




9 


10 




10 




10 


11 




11 




11 


12 




12 




12 


13 




13 




13 


14 




14 




14 


15 




15 




15 


16 




16 




16 












1 












1 












1 












1 












1 
























































1 












1 












1 




1 







I 




1 







1 




1 






















95 




pYnpripnpp ff\ 
















L>AlJtl l^ll^t fr 1 


















Experience #2 
















Experience #3 
















59. 


Wiio started this? 
1. You 2. Other person 


Exper 

1 
1 


.#1 

2 
2 


Exper. #2 

1 2 
1 2 


Exper. #3 

1 2 
1 2 


60. 


Did other person threaten or force you? 
2. Yes 1. A little 0. No 


2 


1 





2 


1 




2 1 


61. 


Did other person try to bribe you with promises, candy, money, etc. 
1. Yes 0. No 


1 







I 





1 





62. 


Had the other person been drinking or using drugs? 
1. Yes 0. No 


1 







1 





1 





63. 


Had you been drinking or using drugs? 
1. Yes 0. No 


1 







1 





1 





64. 


Please estimate how many times you had a sexual experience with 
this person. 






























65. 


Over how long a time did this go on? (Indicate number of days, 
months, years). 

Which of these would best describe your reaction at the time 
of the experience? 

1. Fear 4. Interest 

2. Shock 5. Pleasure 

3. Surprise 
















66. 




1 
2 
3 
4 
5 






1 

2 
3 
4 
5 




1 
2 
3 
4 
5 


67. 
68. 


At the time it happened, who did you tell about this, if anyone? 
YES =1 NO = 

1 . No one 

2. Father 

3. Mother 

4. Other adult 

5. Brother/sister 

6. Friend 

7. Other, please specify 

Did you ever tell anyone about this experience? 
1. Yes 0. No 


Y 

1 
1 
1 
1 
1 
1 




N 









Y 

1 

1 
1 
1 
1 
1 


N 









Y 

1 
1 
1 

1 
1 
1 


N 









1 







1 





1 





69. 


Was this experience ever reported to the police? 
1. Yes 0. No 


1 







1 





1 





70. 


Have you ever talked to a counselor about this experience? 
1. Yes 0. No 


Exper. 
1 


#1 




Exper. #2 
1 


Exper. #3 
1 



96 
71. At the time, how did you fee! about the experience? 



72. 



73. 



1. Positive 


1 


1 


1 


2. Mostly positive 


2 


2 


2 


3. Neutral 


3 


3 


3 


4. Mostly Negative 


4 


4 


4 


5. Negative 


5 


5 


5 


In retrospect, what kind of effect did this experience have on your life? 








1. Positive 


1 


1 


1 


2. Mostly positive 


2 


2 


2 


3. Neutral 


3 


3 


3 


4. Mostly Negative 


4 


4 


4 


5. Negative 


5 


5 


5 


What effect do you think this experience had on the other person? 








I. Positive 


1 


1 


1 


2. Mostly positive 


2 


2 


2 


3. Neutral 


3 


3 


3 


4. Mostly Negative 


4 


4 


4 


5. Negative 


5 


5 


5 



NOW GO BACK TO QUESTION #54 AND ANSWER THE QUESTIONS ABOUT OTHER 
EXPERIENCES. IF NO MORE EXPERIENCES, ANSWER THE FOLLOWING QUESTION AND 
THEN GO ON TO PART C. 

74. Pick one of these experiences and describe how it started. Please use the back of this page to write 
your answer. 

PARTC 
The next series of questions concerns violence in the family. 

75. Think back to the time when you were 1 2 years old. During that year, did your mother ever hit, 
strike, or in any way attempt to physically harm your father? 

1 . Never 

2. Once or twice 

3. A few times each year 

4. Once a month 

5. Every week 

6. More often than once a week 

76. During that year, did your father ever hit, strike, or in any way attempt to physically harm your 
mother? 

1. Never 

2. Once or twice 

3. A few times each year 

4. Once a month 

5. Every week 

6. More often than once a week 

77. Did you ever see your mother hit, strike, or physically harm your father? 
1. Yes 0. No 

78. Did you ever see your father hit, strike, or physically harm your mother'' 
1. Yes 0. No 



97 
79. When you were 12 years old, how often would your father or mother spank you? 

Mother Father 

1. Never 1. Never 

2. Once or twice 2. Once or twice 

3. A few times each year 3. A few times each year 

4. Once a month 4. Once a month 

5. Every week 5, Every week 

6. More often than once a week 6. More often than once a week 



80. 



84. 



Before you were 1 8 years old, were you EVER physically abused by your father? 
1. Yes 0. No 



8 1 . Before you were 1 8 years old, were you EVER physically abused by your mother? 
1. Yes 0. No 

PARTD 

82. Which of the following best describes how fi-equently in the past month you engaged in sexual 
intercourse with a woman? 

0. I have never engaged in sexual intercourse 

1. I have engaged in sexual intercourse, but not in the past month. 

2. 1-5 times in the past month 

3. 6-10 times in the past month 

4. 11-15 times in the past month 

5. 1 6-20 times in the past month 

6. More than 20 times in the past month 

83. How many women have you had sexual intercourse with? 

0. None 

1. One 

2. Two 

3. 3-5 

4. 6-10 

5. 11-15 

6. 16-20 

7. More than 20 



After age 16, how many men have you had a sexual experience with? 
0. None 



1. One 

2. Two 

3. 3-5 

4. 6-10 

5. 11-15 

6. More than 1 5 



98 



85. Please circle appropriate answer: 
Have you ever... 

1 . Had a drinking problem? 

2. Had a drug problem? 

3. Attempted suicide? 

4. Been hospitalized for emotional problems? 

5. Run away from home? 

6. Been arrested? 

7. Were you sexually abused as a child? 

8. Do you consider yourself to have a sexual problem? 

9. Had periods of sexual promiscuity? 

10. Been treated for emotional problems? 

11. Had problems with premature ejaculation? 

12. Had problems in achieving or maintaining an erection? 

13. Did you ever sexually abuse a child? 

14. Do you consider yourself to be homosexual? 

For the next series of questions, circle the number which best reflects your response. 

86. On the following scale, rate your overall sexual adjustment: 

12 3 4 

Poorly adjusted Average 

87. On the following scale, rate your current overall adjustment: 



1 



3 



Poorly adjusted Average 

88. How satisfied are you with your current frequency of sexual behavior? 

12 3 4 

Very Satisfied 

89. Do you worry about being a homosexual? 

12 3 4 

Not at all 

90. Do your sexual fantasies ever involve young teenage girls? 

1 2 3 4 

Never 

91. Do your sexual fantasies ever involve young teenage boys? 

' 2-3 4 

Never 

92. Do your sexual fantasies ever involve young girls? 

1 2 3 4 

Never 



Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 


Yes 


No 



Well adjusted 



Well adjusted 



Very Dissatisfied 



Very Often 



Very Often 



Very Often 



Very Often 



93. Do your sexual fantasies ever involve young boys? 

1,2. 3 

Never 

94. Please rate how sexually appealing you find the following: 

1 2 3 

Not at all 



1. Adult women 

2. Adult men 

3. Teenage girls 

4. Teenage boys 

5. Pre-adolescent girls 

6. Pre-adolescent boys 

7. Young girls 

8. Young boys 



95. 



Are you sexually attracted to children? 



1 

Not at all 



■"2 



;^;' 



2 
2 
2 
2 
2 
2 
2 
2 



99 



Very Often 



Very sexually 
appealing 



4 
4 
4 
4 
4 
4 
4 
4 



Very Often 



96. How likely would you be to have sex with a child if no one would know and you could not be 

punished? 



1 2 3 

Very likely • 

97. How often do you become sexually aroused by a child? 

1 2 ,3 

Not at all . .^ 



Not likely 



Very Often 













100 


98. The following is a list of situations that involve some degree of sexual 


intimacy. 


Some of the 


situations described are experiences which you and your sexual partner desired equally. ' 


The other 




situations described are experiences which were not equally desired by you and 


your 


sexual partner 


■. Think 


back over all the sexual experiences that you have had and try to respond as honestly 


as you can as 


to how 


you have ACTUALLY BEHAVED in the past. Respond to each item by circlir 


igthe 


appropriate number 


which corresponds with the correct frequency. Respond to ALL items including all numbered items (1,2, 


3, etc.) and lettered items (A, B, C, etc.). 












12 3 


4 








5 


Never Once Twice 3-5 times 6-10 times 


More than 10 










times 


1 . I have placed my hand on a woman's breast, thigh, or crotch with her clear 





1 


2 


3 


4 5 


consent 












2. I have placed my hand on a woman's breast, thigh, or crotch against her 





1 


2 


3 


4 5 


wishes 












a) ...by just doing it even though I knew she didn't want to or by 





1 


2 


3 


4 5 


ignoring her protests and statements that she wanted me to stop 












b) ...by persuading her through continued verbal arguments or by 












telling her things I did 












not really mean 





1 


2 


3 


4 5 


c) ...by giving her enough alcohol and/or drugs so that she couldn't 





1 


2 


3 


4 5 


stop me 












d) ...by using verbal threats such as "You'll have to walk home..." 





1 


2 


3 


4 5 


e) ...by using threats of physical force 





1 


2 


3 


4 5 


f) ...by using physical restraint (holding her down, etc.) or physical 





1 


2 


3 


4 5 


force (twisting her arm, etc.) 












3. 1 have removed or disarranged a woman's clothing or underclothing with her 





1 


2 


3 


4 5 


clear consent 












4. 1 have removed or disarranged a woman's clothing or underclothing against 





1 


2 


3 


4 5 


her wishes 












a) ...by just doing it even though I knew she didn't want to or by 





1 


2 


3 


4 5 


ignoring her protests and statements that she wanted me to stop 












b) ...by persuading her through continued verbal arguments or by 





1 


2 


3 


4 5 


telling her things I did not really mean 












c) ...by giving her enough alcohol and/or drugs so that she couldn't 





1 


2 


3 


4 5 


stop me 












d) ...by using verbal threats such as "You'll have to walk home..." 





1 


2 


3 


4 5 


e) ...by using threats of physical force 





1 


2 


3 


4 5 


f) ...by using physical restraint (holding her down, etc.) or physical 





1 


2 


3 


4 5 


force (twisting her arm, etc.) 












5. I have touched a woman's genital area with her clear consent 





1 


2 


3 


4 5 



101 

12 3 4 5 

Never Once Twice 3-5 times 6-10 times More than 10 



times 



6. I have touched a woman's genital area against her wishes 

a) ...by just doing it even though I knew she didn't want to or by 
ignoring her protests and statements that she wanted me to stop 

b) ...by persuading her through continued verbal arguments or by 
telling her things I did not really mean 

c) ...by giving her enough alcohol and/or drugs so that she couldn't 
stop me 

d) ...by using verbal threats such as "You'll have to walk home..." 

e) ...by using threats of physical force 

f) ...by using physical restraint (holding her down, etc.) or physical 
force (twisting her arm, etc.) 

7. I have attempted intercourse with a woman against her wishes, but for some 1 
reason intercourse did not occur. 1 attempted this... 

a) ...by just doing it even though I knew she didn't want to or by 
ignoring her protests and statements that she wanted me to stop 

b) ...by persuading her through continued verbal arguments or by 
telling her things I did not really mean 

c) ...by giving her enough alcohol and/or drugs so that she couldn't 
stop me 

d) ...by using verbal threats such as "You'll have to walk home..." 

e) ...by using threats of physical force 

f) ...by using physical restraint (holding her down, etc.) or physical 
force (twisting her arm, etc.) 

8. I have had sexual intercourse with a woman with her clear consent 

9. 1 have had sexual intercourse with a woman against her wishes, 

a) ...by just doing it even though 1 knew she didn't want to or by 
ignoring her protests and statements that she wanted me to stop 

b) ...by persuading her through continued verbal arguments or by 
telling her things I did not really mean 

c) ...by giving her enough alcohol and/or drugs so that she couldn't 
stop me 

d) ...by using verbal threats such as "You'll have to walk home..." 

e) ...by using threats of physical force 

f) ...by using physical restraint (holding her down, etc.) or physical 
force (twisting her arm, etc.) 






1 


2 


3 


4 


5 





1 


2 


3 


4 


5 





1 


2 


3 


4 


5 





1 


2 


3 


4 


5 





1 


2 


3 


4 


5 





1 


2 


3 


4 


5 





I 


2 


3 


4 


5 








2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 







2 


3 


4 


5 



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104 

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BIOGRAPHICAL SKETCH 

Sidney Michael Trantham was born and raised in Schenectady, New York. He 
attended Brown University where he graduated in 1991 with a Bachelor of Arts degree in 
psychology. In 1991, he began graduate studies in clinical psychology at the University 
of Florida, where he received a Master of Science degree in 1995. Sidney currently 
resides in Cambridge, Massachusetts. 



•: -^ i: 



106 



I certify that I have read this study and that in my opinion it conforms to 
acceptable standards of scholarly presentation and is fully adequate, in scope and quality, 
as a dissertation for the degree of Doctor of^ilosophy. 



Duane E. Dede, Chair 
Clinical Assistant Professor of 
Clinical and Health Psychology 



I certify that I have read this study and that in my opinion it conforms to 
acceptable standards of scholarly presentation and is fully adequate, in scope and quality, 
as a dissertation for the degree of Doctor of Philosc«)hy. 





Gary R. Qeffken 
Associate Professor of 
Clinical and Health Psychology 



I certify that I have read this study and that in my opinion it conforms to 
acceptable standards of scholarly presentation and is flilly adequate, in scope and quality, 
as a dissertation for the degree of Doctor of Philosophy. 




lichael E. Robinson 
Associate Professor of 
Clinical and Heahh Psychology 



I certify that I have read this study and that in my opinion it conforms to 
acceptable standards of scholarly presentation and is fully adequate, in scope and quality, 
as a dissertation for the degree of Doctor of Philosophy. 



in 



Marv Hov^a 




lary Howard-Hamilton 
Associate Professor of Counselor Education 



I certify that I have read this study and that in my opinion it conforms to 
acceptable standards of scholarly presentation and is fully adequate, in scope and quality, 
as a dissertation for the degree of Doctor of Philosophy. 




Iicneile V. Jacobs 
Associate Professor of Law 




This dissertation was submitted to the Graduate Faculty of the College of Health 
Professions and to the Graduate School and was accepted as partial flilfiUment of the 
requirements for the degree of Doctor of Philosophy. 

May 1999 J<^iU'^ <2>"^r/^^i^/C 



Dean, College of Health Professions 



Dean, Graduate School 



UNIVERSITY OF FLORIDA 



3 1262 08555 2932